{"reporting_entity_name": "GHP_HMO","reporting_entity_type": "GHP - Health Insurance Company","last_updated_on": "2026-10-07","version": "2.0","provider_references": [ {"provider_group_id":244010155,"network_name":[],"provider_groups":[{"npi":[1669523320,1902804552,1952452617],"tin":{"type":"ein","value":"230465970","business_name":"Chambersburg Hospital"}}]} ], "in_network" : [ {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1038","description":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp 80-89 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3079F","description":"Diast bp 80-89 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate pt use of inhaler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94664","description":"Evaluate pt use of inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66987","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI fetal ea addl gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74713","description":"MRI fetal ea addl gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ampicillin 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0290","description":"Ampicillin 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF0","description":"ICD-GITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52356","description":"Cysto/uretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA0","description":"ICD-BEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC0","description":"ICD-KEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary cath anchor device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4333","description":"Urinary cath anchor device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch on barr w/flng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5073","description":"Urinary pouch on barr w/flng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext antenna phren nerve stim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8696","description":"Ext antenna phren nerve stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD1","description":"ICD-BECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5117","description":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","description":"CPT-00920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg myelomeningo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2404","description":"Fetal surg myelomeningo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD1","description":"ICD-IFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB31","description":"ICD-2GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC0","description":"ICD-JDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD0","description":"ICD-DFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF0","description":"ICD-FFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD0","description":"ICD-LEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51500","description":"Removal of bladder cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB0","description":"ICD-LBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB0","description":"ICD-ICLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF0","description":"ICD-JACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0703","description":"CDT-D0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upr/lxtr art stdy 3+ lvls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93923","description":"Upr/lxtr art stdy 3+ lvls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB1","description":"ICD-OCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC0","description":"ICD-CBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE1","description":"ICD-CEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"LU GNOTYP BCAM EXON 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196U","description":"LU GNOTYP BCAM EXON 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fees w/laryngeal sense test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92616","description":"Fees w/laryngeal sense test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD0","description":"ICD-GITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide villus sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76945","description":"Echo guide villus sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch urine w lock flng/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4434","description":"Ost pch urine w lock flng/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA1","description":"ICD-KBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX20","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD0","description":"ICD-IIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1445","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","description":"HCPCS-M1445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE1","description":"ICD-OLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE0","description":"ICD-MGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","description":"HCPCS-J3291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8D","description":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1449","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","description":"HCPCS-M1449","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX51","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF1","description":"ICD-MHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC21","description":"ICD-1IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB0","description":"ICD-NENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1279","description":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF1","description":"ICD-BCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE0","description":"ICD-JGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9902","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE0","description":"ICD-BHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disconnect insert locking wr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6616","description":"Disconnect insert locking wr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC0","description":"ICD-EIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abdl tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22901","description":"Exc abdl tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28072","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd lesion ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43270","description":"Egd lesion ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11606","description":"Exc tr-ext mal+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF1","description":"ICD-MGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB0","description":"ICD-EDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd inhal anesthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4554F","description":"Pt recvd inhal anesthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0846T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31253","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE1","description":"ICD-BGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC0","description":"ICD-AHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE1","description":"ICD-MHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA0","description":"ICD-EGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0538T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD0","description":"ICD-AHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD1","description":"ICD-BHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81542","description":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB1","description":"ICD-EFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psych disorders assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3700F","description":"Psych disorders assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA0","description":"ICD-JBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Morcellator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1782","description":"Morcellator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endocrinology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4004","description":"Endocrinology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diethylstilbestrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9165","description":"Diethylstilbestrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psa screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0103","description":"Psa screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB1","description":"ICD-FIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA1","description":"ICD-KEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE1","description":"ICD-NIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9939","description":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald_ tv caption decoder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5271","description":"Ald_ tv caption decoder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA1","description":"ICD-MHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aldolase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82085","description":"Assay of aldolase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen crosslinking cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402T","description":"Collagen crosslinking cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33977","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB1","description":"ICD-KHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED0","description":"ICD-IFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","description":"CPT-00635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86008","description":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O shoe convert to sof counte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3590","description":"O shoe convert to sof counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE0","description":"ICD-GCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81323","description":"Pten gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1283","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo_ colon_ retro imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1749","description":"Endo_ colon_ retro imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE0","description":"ICD-BFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF1","description":"ICD-ACTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surg reduct osseoustuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7485","description":"Surg reduct osseoustuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC1","description":"ICD-PLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC0","description":"ICD-FFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 2-8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88187","description":"Flowcytometry/read 2-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA0","description":"ICD-HAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5C","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27230","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE0","description":"ICD-KIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44385","description":"Endoscopy of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture partial max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5864","description":"Overdenture partial max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescent antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86256","description":"Fluorescent antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB0","description":"ICD-FCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA1","description":"ICD-ODTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA1","description":"ICD-KHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6056","description":"Prefabricated abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1323","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE1","description":"ICD-OKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8I","description":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD1","description":"ICD-BAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC51","description":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Req ret or w/in 90d of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9514","description":"Req ret or w/in 90d of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF1","description":"ICD-OIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF1","description":"ICD-IFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27842","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiemetic rectal/supp nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8498","description":"Antiemetic rectal/supp nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE0","description":"ICD-JDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296U","description":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8I","description":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE0","description":"ICD-EETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35256","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hcg free betachain test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84704","description":"Hcg free betachain test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27111","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC1","description":"ICD-GCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC1","description":"ICD-PJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE0","description":"ICD-MEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","description":"HCPCS-M1412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE0","description":"ICD-OBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB1","description":"ICD-IGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symes type poster opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5634","description":"Symes type poster opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9029","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC31","description":"ICD-4IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC0","description":"ICD-KEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF0","description":"ICD-NIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF0","description":"ICD-HBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE0","description":"ICD-OAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD1","description":"ICD-KHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0623T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA0","description":"ICD-OKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403U","description":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx/proph/dg addl seq iv inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96367","description":"Tx/proph/dg addl seq iv inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3358","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of chromium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82495","description":"Assay of chromium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF0","description":"ICD-OCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fxnl status assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1170F","description":"Fxnl status assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF1","description":"ICD-NDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDerm glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2017","description":"PermeaDerm glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX56","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA1","description":"ICD-CDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF1","description":"ICD-GGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test antiglob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86922","description":"Compatibility test antiglob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF0","description":"ICD-IHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC0","description":"ICD-MGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB0","description":"ICD-JCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ naxitamab-gqgk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9348","description":"Injection_ naxitamab-gqgk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE1","description":"ICD-CGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology lab procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89240","description":"Pathology lab procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59410","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth major vein ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88251","description":"Anesth major vein ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser surg penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54057","description":"Laser surg penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF0","description":"ICD-CDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59121","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF0","description":"ICD-BIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv col supp adj bar & thor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0200","description":"Cerv col supp adj bar & thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB0","description":"ICD-IHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA1","description":"ICD-KCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC1","description":"ICD-NBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Voltage-Gated Calcium Channel Antibody_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86596","description":"Voltage-Gated Calcium Channel Antibody_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","description":"HCPCS-E1033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB0","description":"ICD-EFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9317","description":"No doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA1","description":"ICD-KCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190T","description":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA0","description":"ICD-OEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF0","description":"ICD-CCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE0","description":"ICD-NATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD0","description":"ICD-GIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA1","description":"ICD-CHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF0","description":"ICD-KCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81335","description":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met uptake","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78020","description":"Thyroid met uptake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC45","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF0","description":"ICD-GFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23929","description":"Shoulder surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB1","description":"ICD-EBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental prophylaxis child","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1120","description":"Dental prophylaxis child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","description":"HCPCS-Q4418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SurFactor or NuDyn_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4233","description":"SurFactor or NuDyn_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2001","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1576","description":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of head brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20661","description":"Application of head brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE0","description":"ICD-GHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dent sutur recent wnd to 5cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7910","description":"Dent sutur recent wnd to 5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0103","description":"Residential Habilitation 4-8 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD0","description":"ICD-KFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA0","description":"ICD-GFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs bil 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71110","description":"X-ray exam ribs bil 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA0","description":"ICD-FIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC126","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","description":"HCPCS-J0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28298","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF0","description":"ICD-JCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA0","description":"ICD-JGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF0","description":"ICD-ADBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screening not provided_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9925","description":"Safety concerns screening not provided_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD1","description":"ICD-BEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8532","description":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD1","description":"ICD-ODOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA1","description":"ICD-PDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 VAC AD26 .5ML B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034A","description":"ADM SARSCOV2 VAC AD26 .5ML B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE1","description":"ICD-EETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal ca screen doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3017F","description":"Colorectal ca screen doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC1","description":"ICD-AAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90593","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","description":"CPT-90593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE1","description":"ICD-IDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB1","description":"ICD-NLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD1","description":"ICD-KFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27881","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE0","description":"ICD-MCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF1","description":"ICD-CGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36222","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial custom socket insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5683","description":"Initial custom socket insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB0","description":"ICD-BIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA0","description":"ICD-GCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49428","description":"Ligation of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC1","description":"ICD-CIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8724","description":"Pt_ pn_ hist grade not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43310","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0054","description":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC1","description":"ICD-CBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC1","description":"ICD-JFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quant results activity &symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3115F","description":"Quant results activity &symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA0","description":"ICD-BFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysin acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85475","description":"Hemolysin acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA0","description":"ICD-CAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF0","description":"ICD-OLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9318","description":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE0","description":"ICD-HCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eribulin mesylate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9179","description":"Eribulin mesylate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA1","description":"ICD-MJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0498U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","description":"CPT-0498U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA04","description":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE1","description":"ICD-MBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB0","description":"ICD-BDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92622","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD1","description":"ICD-OEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of large bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44025","description":"Incision of large bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60271","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL54","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28290","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7561","description":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE0","description":"ICD-CHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33267","description":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF1","description":"ICD-OCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC1","description":"ICD-BFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of hip joint/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27036","description":"Excision of hip joint/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF0","description":"ICD-JBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC1","description":"ICD-EACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA31","description":"ICD-4BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE0","description":"ICD-GCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC1","description":"ICD-BBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0564U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","description":"CPT-0564U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE0","description":"ICD-PHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC1","description":"ICD-IHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA0","description":"ICD-FIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB50","description":"Medium Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sunglass frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0518","description":"Sunglass frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA0","description":"ICD-OGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of digoxin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80162","description":"Assay of digoxin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF0","description":"ICD-KEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA0","description":"ICD-ACBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt education noc group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9446","description":"Pt education noc group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2183","description":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC0","description":"ICD-KGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA0","description":"ICD-FITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF0","description":"ICD-HFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA0","description":"ICD-CGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for vulva lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56440","description":"Surgery for vulva lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49429","description":"Removal of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33430","description":"Replacement of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test non-trep qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86592","description":"Syphilis test non-trep qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of homovanillic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83150","description":"Assay of homovanillic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gated heart multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78473","description":"Gated heart multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA0","description":"ICD-ADUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE1","description":"ICD-CEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE0","description":"ICD-CDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF0","description":"ICD-JBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0909T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","description":"CPT-0909T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart rhythm pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93618","description":"Heart rhythm pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB1","description":"ICD-EHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic mitomycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7315","description":"Ophthalmic mitomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exam of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56820","description":"Exam of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF1","description":"ICD-LHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0641T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breath recording infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94772","description":"Breath recording infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD1","description":"ICD-JHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD0","description":"ICD-EDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8X","description":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF0","description":"ICD-LAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD1","description":"ICD-JAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD1","description":"ICD-KIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99155","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ transvenous vdd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1779","description":"Lead_ pmkr_ transvenous vdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96133","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/tc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88185","description":"Flowcytometry/tc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND1","description":"ICD-FDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA0","description":"ICD-BFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE236","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA1","description":"ICD-OAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","description":"HCPCS-Q4398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4348","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","description":"HCPCS-Q4348","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE1","description":"ICD-OFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulp cap direct","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3110","description":"Pulp cap direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282U","description":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF1","description":"ICD-OCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD1","description":"ICD-OAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE1","description":"ICD-PDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB0","description":"ICD-KBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE0","description":"ICD-KEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA1","description":"ICD-KDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107U","description":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC0","description":"ICD-BIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC0","description":"ICD-BAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB1","description":"ICD-JFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES114","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45805","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE0","description":"ICD-BFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infusion 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96413","description":"Chemo iv infusion 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF0","description":"ICD-ODCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/medstnl bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39401","description":"Mediastinoscpy w/medstnl bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide ova aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76948","description":"Echo guide ova aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF0","description":"ICD-GEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE1","description":"ICD-KBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC0","description":"ICD-CCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB1","description":"ICD-BHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX50","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","description":"HCPCS-M1425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC0","description":"ICD-NLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Als iv drug therapy supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0394","description":"Als iv drug therapy supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA1","description":"ICD-AHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC0","description":"ICD-GBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF1","description":"ICD-FBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE0","description":"ICD-AGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Planar back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2291","description":"Planar back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF0","description":"ICD-NKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD0","description":"ICD-MILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA1","description":"ICD-NHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99473","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF1","description":"ICD-OBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD1","description":"ICD-NHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8F","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrig drug delivery device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96523","description":"Irrig drug delivery device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy nerve of eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67345","description":"Destroy nerve of eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF0","description":"ICD-NFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1448","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD1","description":"ICD-NBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA1","description":"ICD-BFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rsect hip tum incl femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27078","description":"Rsect hip tum incl femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE1","description":"ICD-HEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory traction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0830","description":"Ambulatory traction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC1","description":"ICD-CFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9059","description":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of mammary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77053","description":"X-ray of mammary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0658","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","description":"HCPCS-E0658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-t9 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0455","description":"Tlso flex trnk sj-t9 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF1","description":"ICD-IFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD1","description":"ICD-NABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC1","description":"ICD-PIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA1","description":"ICD-BCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bamlanivimab and etesevimab_ 2100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0245","description":"Injection_ bamlanivimab and etesevimab_ 2100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0003","description":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB0","description":"ICD-AEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust max prost appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5992","description":"Adjust max prost appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26011","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE1","description":"ICD-KCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF1","description":"ICD-CCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA1","description":"ICD-ODNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepres rxthxpy not rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4063F","description":"Antidepres rxthxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC0","description":"ICD-HCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC0","description":"ICD-OBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND1","description":"ICD-NIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE1","description":"ICD-GGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB0","description":"ICD-EGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB0","description":"ICD-CBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9764","description":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB1","description":"ICD-NCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB0","description":"ICD-MJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB0","description":"ICD-KHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0904","description":"CDT-D0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC0","description":"ICD-BBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5172","description":"HCPCS-Q5172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF1","description":"ICD-BCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD1","description":"ICD-PCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF0","description":"ICD-MBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB0","description":"ICD-BFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67973","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA235","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7566","description":"HCPCS-C7566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE0","description":"ICD-NKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE0","description":"ICD-IIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29530","description":"Strapping of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml remission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9126","description":"Onc dx cml remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF0","description":"ICD-OFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD1","description":"ICD-MHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB1","description":"ICD-IBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL60","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cine/vid x-ray throat/esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74230","description":"Cine/vid x-ray throat/esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube stainless","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7522","description":"Trach/laryn tube stainless","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA0","description":"ICD-JCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80050","description":"General health panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD0","description":"ICD-OLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE0","description":"ICD-MDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE0","description":"ICD-KEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ovulation mgmt per cycle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4042","description":"Ovulation mgmt per cycle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB0","description":"ICD-EFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC1","description":"ICD-GCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD1","description":"ICD-AIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis deafness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3844","description":"Dna analysis deafness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF1","description":"ICD-CCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust toe ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1830","description":"Adjust toe ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc post surg anatomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9613","description":"Doc post surg anatomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB0","description":"ICD-LBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24155","description":"Removal of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE1","description":"ICD-NHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc ref upper gi endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3132F","description":"Doc ref upper gi endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD0","description":"ICD-PBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE0","description":"ICD-OHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4024","description":"Pediatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD0","description":"ICD-MFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME0","description":"ICD-KFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF0","description":"ICD-PASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1C","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","description":"CPT-00832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA1","description":"ICD-EIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0487U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","description":"CPT-0487U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69705","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC0","description":"ICD-GEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB0","description":"ICD-MHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB1","description":"ICD-ABHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD0","description":"ICD-OCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA1","description":"ICD-LEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9366","description":"1high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC1","description":"ICD-IDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC1","description":"ICD-KEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE0","description":"ICD-NJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD0","description":"ICD-OECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC0","description":"ICD-FBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Global eswl kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0400","description":"Global eswl kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF0","description":"ICD-JDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8F","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA0","description":"ICD-AGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC0","description":"ICD-OIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE0","description":"ICD-GBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cap bld skin piercing laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0620","description":"Cap bld skin piercing laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB1","description":"ICD-DBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC0","description":"ICD-OIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24102","description":"Remove elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breathing capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94010","description":"Breathing capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB1","description":"ICD-OCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0434","description":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; spinal accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64412","description":"Injection_ anesthetic agent; spinal accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasma volume single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78110","description":"Plasma volume single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of inner eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66770","description":"Removal of inner eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD1","description":"ICD-OITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD0","description":"ICD-FEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c lateral trunk/hip suppor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0956","description":"W/c lateral trunk/hip suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD1","description":"ICD-KADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0815","description":"Pwc gp 1 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC1","description":"ICD-OEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416U","description":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58605","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE1","description":"ICD-KGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smpd1 gene common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81330","description":"Smpd1 gene common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1080","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport wheelch van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0130","description":"Noner transport wheelch van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1041","description":"Medicaid certified community behavioral health clinic services_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC1","description":"ICD-BADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA1","description":"ICD-MCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pouch w faucet/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4428","description":"Urine ost pouch w faucet/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse liver ducts & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47765","description":"Fuse liver ducts & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31527","description":"Laryngoscopy for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31601","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-2 spine 4/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72110","description":"X-ray exam l-2 spine 4/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE1","description":"ICD-AHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37293","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","description":"CPT-37293","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE0","description":"ICD-NGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csit on pt any reas 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8962","description":"Csit on pt any reas 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic lightbox tabletp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0203","description":"Therapeutic lightbox tabletp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF0","description":"ICD-KCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD0","description":"ICD-JGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64837","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE0","description":"ICD-GIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD1","description":"ICD-CEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77063","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA0","description":"ICD-NKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE1","description":"ICD-GGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spring-ass rot wrst w/ latch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6623","description":"Spring-ass rot wrst w/ latch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26990","description":"Drainage of pelvis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD1","description":"ICD-MJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX36","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362U","description":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6740","description":"Crown porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB0","description":"ICD-ECUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA1","description":"ICD-FCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast noble metal inlay 2 sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6606","description":"Cast noble metal inlay 2 sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brucella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86622","description":"Brucella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID0","description":"ICD-OCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc iliac repr w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34900","description":"Endovasc iliac repr w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF0","description":"ICD-CHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95919","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA0","description":"ICD-CCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB0","description":"ICD-FBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID1","description":"ICD-CFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62142","description":"Remove skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes oxford","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3219","description":"Orthopedic mens shoes oxford","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD1","description":"ICD-FDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF1","description":"ICD-OKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cable mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6580","description":"Wrist/elbow bowden cable mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA53","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC1","description":"ICD-BFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD0","description":"ICD-JGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69436","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC1","description":"ICD-JBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF0","description":"ICD-BHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54250","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0077","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL15","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD1","description":"ICD-MGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Care Practitioners Rendering Treatment In Place (Tip)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2021","description":"Health Care Practitioners Rendering Treatment In Place (Tip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove intestinal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44137","description":"Remove intestinal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srch for ct w in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9341","description":"Srch for ct w in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25931","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1072","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC0","description":"ICD-JIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD1","description":"ICD-BDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38225","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","description":"CPT-38225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0688","description":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","description":"HCPCS-J3404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF0","description":"ICD-KILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE1","description":"ICD-LFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF1","description":"ICD-KELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","description":"CPT-37270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE241","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8G","description":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB0","description":"ICD-MJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF0","description":"ICD-EBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC1","description":"ICD-FBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1273","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilia clot factor noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7199","description":"Hemophilia clot factor noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exam/biopsy of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56821","description":"Exam/biopsy of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA1","description":"ICD-NLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC0","description":"ICD-NLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD0","description":"ICD-OHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD1","description":"ICD-OCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9613","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9613","description":"HCPCS-A9613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB0","description":"ICD-FDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD0","description":"ICD-CFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychi sympt 1+present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1182F","description":"Neuropsychi sympt 1+present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No reason for no hep c rna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9204","description":"No reason for no hep c rna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA0","description":"ICD-EIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD0","description":"ICD-JHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD0","description":"ICD-FGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig lesion>1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7414","description":"Excision malig lesion>1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD1","description":"ICD-CDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE0","description":"ICD-LCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA0","description":"ICD-AAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC0","description":"ICD-OHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC1","description":"ICD-KFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC0","description":"ICD-OAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB0","description":"ICD-FCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA1","description":"ICD-OHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC1","description":"ICD-DCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA1","description":"ICD-BCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49622","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbt w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21395","description":"Opn tx orbit periorbt w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD1","description":"ICD-GIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE0","description":"ICD-JAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE1","description":"ICD-KHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA1","description":"ICD-KIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE1","description":"ICD-EIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3B","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo w/o shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1006","description":"Pwr seat combo w/o shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC0","description":"ICD-OLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF0","description":"ICD-GGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE0","description":"ICD-IBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB1","description":"ICD-OAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF1","description":"ICD-BBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1603","description":"CDT-D1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF1","description":"ICD-JCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA1","description":"ICD-NHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF0","description":"ICD-EECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB1","description":"ICD-CBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE1","description":"ICD-FGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA1","description":"ICD-BAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA160","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE0","description":"ICD-FBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF1","description":"ICD-AABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens single vision not oth c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2199","description":"Lens single vision not oth c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA0","description":"ICD-FCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83528","description":"Assay of intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5090","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC0","description":"ICD-IBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA1","description":"ICD-JEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB1","description":"ICD-CBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1815","description":"Insulin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35539","description":"Art byp grft aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA0","description":"ICD-FCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF1","description":"ICD-CESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0297","description":"Hosp bed total elect w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39541","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC0","description":"ICD-CIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB0","description":"ICD-JHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC1","description":"ICD-KDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC26","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0979T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","description":"CPT-0979T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB0","description":"ICD-BEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB0","description":"ICD-FFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-visit patient screening","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9912","description":"Pre-visit patient screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB0","description":"ICD-BGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81163","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth/nose fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30600","description":"Repair mouth/nose fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442U","description":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF1","description":"ICD-OJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID0","description":"ICD-GEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE1","description":"ICD-ODGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF0","description":"ICD-GETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bia whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358T","description":"Bia whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355U","description":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC0","description":"ICD-PFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC0","description":"ICD-GEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprssion thxpy prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4267F","description":"Comprssion thxpy prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14302","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB0","description":"ICD-IDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD1","description":"ICD-BCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA241","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9093","description":"Injection_ ranibizumab_ via sustained release intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81239","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assessment by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9001","description":"Assessment by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11462","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE0","description":"ICD-IIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA1","description":"ICD-OFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse hand bones with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25825","description":"Fuse hand bones with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE1","description":"ICD-CIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC1","description":"ICD-NGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81518","description":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF0","description":"ICD-NIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC1","description":"ICD-NAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB1","description":"ICD-KAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD1","description":"ICD-JDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB1","description":"ICD-KAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB0","description":"ICD-GHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy wbx sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32604","description":"Thoracoscopy wbx sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB21","description":"ICD-1JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85004","description":"Automated diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB1","description":"ICD-GGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD0","description":"ICD-NKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75651","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD1","description":"ICD-LBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj enoxaparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1650","description":"Inj enoxaparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB1","description":"ICD-GAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC1","description":"ICD-OEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB0","description":"ICD-OASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metabolic panel ionized ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80047","description":"Metabolic panel ionized ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Haloperidol decanoate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1631","description":"Haloperidol decanoate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0995T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","description":"CPT-0995T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC1","description":"ICD-KAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2161","description":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35221","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct malrotation of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44055","description":"Correct malrotation of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD0","description":"ICD-JGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2781","description":"Crown 3/4 cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE0","description":"ICD-GIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74250","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd demo bundle level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9013","description":"Esrd demo bundle level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE0","description":"ICD-GFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF0","description":"ICD-CAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","description":"HCPCS-A2036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF1","description":"ICD-ODYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA216","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME1","description":"ICD-MKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32663","description":"Thoracoscopy w/lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance half arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0655","description":"Pneumatic appliance half arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA0","description":"ICD-FHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental tomographic survey","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0322","description":"Dental tomographic survey","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB1","description":"ICD-GIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF0","description":"ICD-CANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asthma risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2016F","description":"Asthma risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE1","description":"ICD-NHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8010","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8010","description":"HCPCS-C8010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE1","description":"ICD-JHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct upper jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21206","description":"Reconstruct upper jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0505","description":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2162","description":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB1","description":"ICD-MGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE0","description":"ICD-BFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF1","description":"ICD-NFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Counsel prov driving risks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6110F","description":"Counsel prov driving risks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","description":"CPT-98015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB1","description":"ICD-JCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrogastrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91132","description":"Electrogastrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC0","description":"ICD-GIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9878","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36836","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins mark thor for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32553","description":"Ins mark thor for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB1","description":"ICD-ICHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0898","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9433","description":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF1","description":"ICD-NKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4363","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","description":"HCPCS-Q4363","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF0","description":"ICD-FDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC0","description":"ICD-OLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA1","description":"ICD-MIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC0","description":"ICD-CELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA56","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC0","description":"ICD-IHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35301","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-emer transport wait time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2007","description":"Non-emer transport wait time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi protein loss exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78282","description":"Gi protein loss exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2D","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF0","description":"ICD-LCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB1","description":"ICD-NBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24900","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD0","description":"ICD-GHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC1","description":"ICD-PBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24065","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA1","description":"ICD-CIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Htlv-i antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86687","description":"Htlv-i antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC0","description":"ICD-BGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF0","description":"ICD-OJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA1","description":"ICD-KFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC0","description":"ICD-PKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF1","description":"ICD-HIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB1","description":"ICD-NDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA0","description":"ICD-GFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE251","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD1","description":"ICD-HCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME0","description":"ICD-FHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF1","description":"ICD-GFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy lumb/sac facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64635","description":"Destroy lumb/sac facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who screened positive for at least 1 of the 5 hrsns","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1320","description":"Patients who screened positive for at least 1 of the 5 hrsns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA1","description":"ICD-GGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD1","description":"ICD-KEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA1","description":"ICD-KDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24635","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF0","description":"ICD-ECLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427T","description":"Insj/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1143","description":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2607","description":"Skin pro/pos wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD0","description":"ICD-IIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC1","description":"ICD-CEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD1","description":"ICD-GGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supp maint employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2026","description":"Supp maint employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA1","description":"ICD-BFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6554","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA1","description":"ICD-BCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF0","description":"ICD-KDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA1","description":"ICD-JHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD0","description":"ICD-MKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC0","description":"ICD-NKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF0","description":"ICD-MEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tubing (oxygen) per foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4616","description":"Tubing (oxygen) per foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC1","description":"ICD-ADMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0484T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bld typing serologic rh phnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86906","description":"Bld typing serologic rh phnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF0","description":"ICD-OHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA0","description":"ICD-GFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC0","description":"ICD-NJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1096T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1096T","description":"CPT-1096T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE1","description":"ICD-DFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB1","description":"ICD-JGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grp psych partial hosp 45-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0410","description":"Grp psych partial hosp 45-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","description":"CPT-01482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED1","description":"ICD-MIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD0","description":"ICD-KBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE0","description":"ICD-KEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros sheath/sock w gel cushn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8417","description":"Pros sheath/sock w gel cushn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oprelvekin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2355","description":"Oprelvekin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64630","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA1","description":"ICD-FHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE1","description":"ICD-BIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37180","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA1","description":"ICD-JCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99231","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluocinol acet intravit imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7313","description":"Fluocinol acet intravit imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD0","description":"ICD-FGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA21","description":"ICD-4DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF0","description":"ICD-OAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0796T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0161U","description":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9401","description":"No disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB0","description":"ICD-ODSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB1","description":"ICD-OEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA1","description":"ICD-GGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0118","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA1","description":"ICD-BCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB21","description":"ICD-1LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lwr xtr vasc stdy bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93924","description":"Lwr xtr vasc stdy bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC1","description":"ICD-AIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imaging coil_ mr_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1770","description":"Imaging coil_ mr_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c ab test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86803","description":"Hepatitis c ab test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr capsid vca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86665","description":"Epstein-barr capsid vca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE1","description":"ICD-EBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE226","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD0","description":"ICD-OIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE1","description":"ICD-KICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF1","description":"ICD-OHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0C","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD1","description":"ICD-KERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antid glbln rcvd w/in 26wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4178F","description":"Antid glbln rcvd w/in 26wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND1","description":"ICD-NLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA0","description":"ICD-JANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest eye tissue alograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68371","description":"Harvest eye tissue alograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8913","description":"Pt doc no wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF1","description":"ICD-CCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37202","description":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE1","description":"ICD-MJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB1","description":"ICD-EEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF1","description":"ICD-ODQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF0","description":"ICD-JDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC0","description":"ICD-BAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE1","description":"ICD-JAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE0","description":"ICD-NINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5657","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","description":"HCPCS-L5657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90966","description":"Esrd home pt serv p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE0","description":"ICD-HEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF0","description":"ICD-ACBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barrier sld ext wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4385","description":"Ost skn barrier sld ext wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cefazolin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0690","description":"Cefazolin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD1","description":"ICD-EGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB1","description":"ICD-ECBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiograph pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72191","description":"Ct angiograph pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB1","description":"ICD-NITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD0","description":"ICD-HBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm cmplt mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5811","description":"Denture interm cmplt mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29823","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB1","description":"ICD-ECLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99232","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF0","description":"ICD-JAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99152","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA1","description":"ICD-KIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB1","description":"ICD-NCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0518","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA0","description":"ICD-FBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB0","description":"ICD-FABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraor complete film series","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0210","description":"Intraor complete film series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC0","description":"ICD-FDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE1","description":"ICD-CCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD0","description":"ICD-KFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD1","description":"ICD-OJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Christian sci nurse visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9901","description":"Christian sci nurse visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC1","description":"ICD-KDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE0","description":"ICD-NBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post 2 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2392","description":"Post 2 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99190","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD1","description":"ICD-CGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9874","description":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD1","description":"ICD-OKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD0","description":"ICD-OITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND0","description":"ICD-OLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing care in home rn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9123","description":"Nursing care in home rn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA0","description":"ICD-KFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC0","description":"ICD-GAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47537","description":"Removal biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo w/ankle joint_ prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1971","description":"Afo w/ankle joint_ prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0125U","description":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC1","description":"ICD-NBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug_ generic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5000","description":"Prescription drug_ generic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB14","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB0","description":"ICD-GEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE0","description":"ICD-NLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC1","description":"ICD-KFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Position seat spec orth need","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5001","description":"Position seat spec orth need","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77290","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA0","description":"ICD-KIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","description":"CPT-98008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace non-molded calf lace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4055","description":"Replace non-molded calf lace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1836","description":"Ko rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA1","description":"ICD-FGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD0","description":"ICD-KGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB1","description":"ICD-BICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD1","description":"ICD-NFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Actigraphy testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95803","description":"Actigraphy testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA31","description":"ICD-4IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB0","description":"ICD-CCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081A","description":"ADM SARSCV2 3MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD1","description":"ICD-JCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic derotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1260","description":"Anterior thoracic derotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF0","description":"ICD-FBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tendon sheath lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26160","description":"Remove tendon sheath lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85732","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37278","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","description":"CPT-37278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC0","description":"ICD-NFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB1","description":"ICD-GBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99217","description":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF1","description":"ICD-GCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1065","description":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0041","description":"Fos c chld non-ther per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF1","description":"ICD-NCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0805","description":"HCPCS-A0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA50","description":"Very High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE1","description":"ICD-MAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00104","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","description":"CPT-00104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11105","description":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC0","description":"ICD-CCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX32","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD1","description":"ICD-DFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA0","description":"ICD-JIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD205","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3384F","description":"Ajcc cln cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB0","description":"ICD-CHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw < 3 yrs fem/jugular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36400","description":"Bl draw < 3 yrs fem/jugular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE0","description":"ICD-CIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE1","description":"ICD-HEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD1","description":"ICD-EHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA31","description":"ICD-3CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagosc flex trnsn biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43198","description":"Esophagosc flex trnsn biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA1","description":"ICD-BEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","description":"HCPCS-J7601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE0","description":"ICD-OIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15931","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME1","description":"ICD-JEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB0","description":"ICD-DCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99325","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA11","description":"ICD-3JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA1","description":"ICD-JFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB0","description":"ICD-OFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54660","description":"Revision of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF0","description":"ICD-CEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1159","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC01","description":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Igh vari regional mutation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81263","description":"Igh vari regional mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rehab thxpy options w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4400F","description":"Rehab thxpy options w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5168","description":"HCPCS-Q5168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE0","description":"ICD-KBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cervical semi-rigid adjustab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0140","description":"Cervical semi-rigid adjustab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE1","description":"ICD-ABAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ 20 or more elec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1731","description":"Cath_ ep_ 20 or more elec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF1","description":"ICD-NJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA0","description":"ICD-ECLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF0","description":"ICD-CHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC0","description":"ICD-FCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD0","description":"ICD-KDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4D","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF1","description":"ICD-BBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed re comp thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4268F","description":"Pt ed re comp thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD1","description":"ICD-BIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB1","description":"ICD-AAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9130","description":"Onc dx multi myeloma unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC1","description":"ICD-MDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69440","description":"Exploration of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8624","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC1","description":"ICD-GEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply finger cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29086","description":"Apply finger cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE0","description":"ICD-GCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA0","description":"ICD-OIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB11","description":"ICD-4AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE0","description":"ICD-CDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Head control nonproportional","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2329","description":"Head control nonproportional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22847","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Environmental manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90882","description":"Environmental manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mgmt gene methylation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81287","description":"Mgmt gene methylation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF1","description":"ICD-IGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF0","description":"ICD-KHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF0","description":"ICD-GFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409U","description":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB210","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC0","description":"ICD-OJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD0","description":"ICD-MJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB1","description":"ICD-AGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial hosp prog service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0129","description":"Partial hosp prog service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_autosys and md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0141","description":"Scr c/v cyto_autosys and md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0321U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded to patient plasti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1940","description":"Afo molded to patient plasti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC0","description":"ICD-CDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB1","description":"ICD-KDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE1","description":"ICD-OBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE0","description":"ICD-KBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD1","description":"ICD-LDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55869","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","description":"CPT-55869","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF1","description":"ICD-GDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC1","description":"ICD-LCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Waist belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2190","description":"Waist belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE1","description":"ICD-OESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF0","description":"ICD-JFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC1","description":"ICD-NDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB1","description":"ICD-MEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anes medscpy&thorscpy 1 lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52951","description":"Anes medscpy&thorscpy 1 lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC1","description":"ICD-NIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC0","description":"ICD-GGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump opt inst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0478","description":"Drug test presump opt inst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB205","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC234","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF1","description":"ICD-OAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7508","description":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB124","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF1","description":"ICD-KDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF0","description":"ICD-MBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC1","description":"ICD-OJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF1","description":"ICD-GGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF1","description":"ICD-FBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB0","description":"ICD-MGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD1","description":"ICD-PCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0668","description":"Seg pneumatic appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF1","description":"ICD-JDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC23","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF0","description":"ICD-NLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23552","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE155","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA0","description":"ICD-EAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11420","description":"Exc h-f-nk-sp b9+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE1","description":"ICD-KFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF0","description":"ICD-NFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","description":"CPT-00170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB1","description":"ICD-NHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC0","description":"ICD-BEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ACApatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4325","description":"ACApatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF1","description":"ICD-NHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF1","description":"ICD-NEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD1","description":"ICD-OFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX02","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0621T","description":"Trabeculostomy Ab Interno By Laser;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ptnotrcvngsteroid>/=10mg/day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3750F","description":"Ptnotrcvngsteroid>/=10mg/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch for bar w flange/flt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4419","description":"Ost pch for bar w flange/flt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92371","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Direct refer hospital observ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0379","description":"Direct refer hospital observ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC31","description":"ICD-2CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA0","description":"ICD-MDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole sodium_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2470","description":"Injection_ pantoprazole sodium_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB0","description":"ICD-GBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB0","description":"ICD-JIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81306","description":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0C","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD0","description":"ICD-BCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35583","description":"Vein byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intranasal biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30100","description":"Intranasal biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD1","description":"ICD-CHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA0","description":"ICD-EHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77046","description":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70150","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB0","description":"ICD-PBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","description":"HCPCS-Q4417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC1","description":"ICD-KBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC11","description":"ICD-4BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF1","description":"ICD-FHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA1","description":"ICD-HFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB06","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Os pch urine w bar/fange/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4432","description":"Os pch urine w bar/fange/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37618","description":"Ligation of extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD1","description":"ICD-OFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt prgrm for implt neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8681","description":"Pt prgrm for implt neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE1","description":"ICD-CAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD0","description":"ICD-PBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2304","description":"Lens sphcy trifocal 4.0/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD1","description":"ICD-JDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62362","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33534","description":"Cabg arterial two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE1","description":"ICD-FBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC0","description":"ICD-KCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA146","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate conc pow per pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4765","description":"Dialysate conc pow per pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA1","description":"ICD-CGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF0","description":"ICD-AIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98925","description":"Osteopath manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME1","description":"ICD-NIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC0","description":"ICD-HCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC0","description":"ICD-OFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27816","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA0","description":"ICD-EFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74305","description":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE1","description":"ICD-NIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00902","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","description":"CPT-00902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28270","description":"Release of foot contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB1","description":"ICD-PHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF0","description":"ICD-GDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB0","description":"ICD-EFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9774","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22102","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD0","description":"ICD-ODSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Right ventricular recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93603","description":"Right ventricular recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic tx addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96571","description":"Photodynamic tx addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF0","description":"ICD-EBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behav chng smoking 3-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99406","description":"Behav chng smoking 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80081","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF0","description":"ICD-FFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43262","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB1","description":"ICD-JDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC1","description":"ICD-JDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC1","description":"ICD-KGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD0","description":"ICD-IBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-CDC SARS-CoV-2/2019-nCoV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0002","description":"Non-CDC SARS-CoV-2/2019-nCoV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD0","description":"ICD-DDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA1","description":"ICD-CETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj reshaping components","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7865","description":"Tmj reshaping components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD0","description":"ICD-EHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61001","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC0","description":"ICD-IABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral periapical first f","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0220","description":"Intraoral periapical first f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27265","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33860","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ctr mount pwr elev leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1012","description":"Ctr mount pwr elev leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj trigger point 1/2 muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20552","description":"Inj trigger point 1/2 muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0A","description":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9391","description":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE1","description":"ICD-NHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF1","description":"ICD-IHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF1","description":"ICD-MICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78270","description":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE1","description":"ICD-EGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB0","description":"ICD-NJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE0","description":"ICD-ACAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC16","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE0","description":"ICD-KHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnio Wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4181","description":"Amnio Wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","description":"CPT-64567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD0","description":"ICD-EHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF1","description":"ICD-KIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID1","description":"ICD-JDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg shlder/t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6384","description":"Postop dsg cast chg shlder/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruct lesion 15 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17111","description":"Destruct lesion 15 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA0","description":"ICD-GEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE1","description":"ICD-KHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert temp bladder cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51702","description":"Insert temp bladder cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99336","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE0","description":"ICD-EDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7192","description":"Factor viii recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD0","description":"ICD-DAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ diag/abl_ 3d/vect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1732","description":"Cath_ ep_ diag/abl_ 3d/vect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB1","description":"ICD-MLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD0","description":"ICD-NJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA1","description":"ICD-HBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE0","description":"ICD-DCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC1","description":"ICD-NLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC1","description":"ICD-PBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF0","description":"ICD-GAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1000","description":"Clinical Decision Support Mechanism Applied Pathways_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33300","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF1","description":"ICD-HCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous islet celltrans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0341","description":"Percutaneous islet celltrans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE245","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); blocking antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86042","description":"Acetylcholine receptor (AChR); blocking antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc p aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4021","description":"Ivf canc p aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC1","description":"ICD-NFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0574","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0574","description":"HCPCS-G0574","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5C","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25442","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC0","description":"ICD-BAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA1","description":"ICD-BBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF1","description":"ICD-GFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF1","description":"ICD-KITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgmdsc w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45350","description":"Sgmdsc w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC1","description":"ICD-KDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9946","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87154","description":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB1","description":"ICD-OIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF1","description":"ICD-BIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37249","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB1","description":"ICD-OGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous carboxyhb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88740","description":"Transcutaneous carboxyhb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i&ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86828","description":"Hla class i&ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF1","description":"ICD-AEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF0","description":"ICD-ACMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC1","description":"ICD-KIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC1","description":"ICD-BEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB1","description":"ICD-KERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4B","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB0","description":"ICD-NFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC150","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF0","description":"ICD-NIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB1","description":"ICD-EGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF1","description":"ICD-MGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC0","description":"ICD-HHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L2221","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","description":"HCPCS-L2221","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD1","description":"ICD-IDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB0","description":"ICD-OGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF0","description":"ICD-CEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8D","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy supfc palmar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64823","description":"Sympathectomy supfc palmar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF1","description":"ICD-EFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB0","description":"ICD-JFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0903","description":"HCPCS-B0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ans parasymp & symp w/tilt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95924","description":"Ans parasymp & symp w/tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision/fixation of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27165","description":"Incision/fixation of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB1","description":"ICD-IDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID0","description":"ICD-BIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB0","description":"ICD-NGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90958","description":"Esrd srv 2-3 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES313","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE1","description":"ICD-OHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise finger tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26055","description":"Incise finger tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ossicular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8613","description":"Ossicular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF0","description":"ICD-IABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electron microscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88348","description":"Electron microscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE1","description":"ICD-NDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB0","description":"ICD-KCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC116","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4038","description":"Cast sup shrt leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99421","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0906T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","description":"CPT-0906T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC0","description":"ICD-JAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transdermal gfr monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0603T","description":"Transdermal gfr monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE1","description":"ICD-GHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk imaging tst not ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3331F","description":"Bk imaging tst not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4013","description":"Cast sup gauntlet plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB44","description":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF1","description":"ICD-OLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC0","description":"ICD-CBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC0","description":"ICD-CGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69601","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB05","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anastomosis/artery-aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33606","description":"Anastomosis/artery-aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC1","description":"ICD-NJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA1","description":"ICD-FFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC0","description":"ICD-CCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB1","description":"ICD-KABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA0","description":"ICD-GHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ during operative procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73530","description":"Radiologic examination_ hip_ during operative procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC1","description":"ICD-CCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF1","description":"ICD-ICHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy intracavitary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96440","description":"Chemotherapy intracavitary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE1","description":"ICD-CACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC0","description":"ICD-KBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF1","description":"ICD-FFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF0","description":"ICD-BBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE1","description":"ICD-FCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA31","description":"ICD-2JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB0","description":"ICD-PJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE1","description":"ICD-AAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of troponin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84512","description":"Assay of troponin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF1","description":"ICD-CATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC0","description":"ICD-BAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA1","description":"ICD-EFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA1","description":"ICD-NANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA1","description":"ICD-LDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF1","description":"ICD-FHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF0","description":"ICD-GDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No bone scn b/4 txmnt/aftrdx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3270F","description":"No bone scn b/4 txmnt/aftrdx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78299","description":"Gi nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED1","description":"ICD-FBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC0","description":"ICD-MIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE1","description":"ICD-OFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icm/ilr remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93299","description":"Icm/ilr remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD1","description":"ICD-JFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0928T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","description":"CPT-0928T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE0","description":"ICD-DFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE1","description":"ICD-OEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96377","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1025","description":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD1","description":"ICD-FBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lesion destruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7465","description":"Lesion destruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE0","description":"ICD-GETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE0","description":"ICD-NCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES134","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD0","description":"ICD-NGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst including t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58262","description":"Vag hyst including t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA1","description":"ICD-OKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar bolster pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1030","description":"Lumbar bolster pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB0","description":"ICD-AELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA0","description":"ICD-CIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB0","description":"ICD-CHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scr unheal etoh w/counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9621","description":"Scr unheal etoh w/counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99281","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD0","description":"ICD-JIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC1","description":"ICD-JAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC BRST CA DNA PIK3CA 11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0177U","description":"ONC BRST CA DNA PIK3CA 11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst incl t/o complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58291","description":"Vag hyst incl t/o complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33516","description":"Cabg vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9481","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA1","description":"ICD-DDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp ge 130 - 139mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3075F","description":"Syst bp ge 130 - 139mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF1","description":"ICD-GBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1051T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1051T","description":"CPT-1051T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA1","description":"ICD-ACBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA1","description":"ICD-BAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF0","description":"ICD-PJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF0","description":"ICD-OFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ivf package","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4011","description":"Ivf package","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF1","description":"ICD-CEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB1","description":"ICD-MCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD1","description":"ICD-NDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acid conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4709","description":"Acid conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Salivary surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42699","description":"Salivary surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA0","description":"ICD-KCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45540","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC1","description":"ICD-DIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Free omental flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49906","description":"Free omental flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND1","description":"ICD-BFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37182","description":"Insert hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr adpt pneum vad_ rep veh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0504","description":"Pwr adpt pneum vad_ rep veh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD0","description":"ICD-CGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD1","description":"ICD-NILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC0","description":"ICD-GIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF0","description":"ICD-CCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Refer to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9524","description":"Refer to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Internal root repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3333","description":"Internal root repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF0","description":"ICD-NGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE0","description":"ICD-KFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6721","description":"Hook/hand_ hvy dty_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9334","description":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF1","description":"ICD-BHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8702","description":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND0","description":"ICD-BGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB1","description":"ICD-FBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0104","description":"HCPCS-C0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID1","description":"ICD-KFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53250","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED0","description":"ICD-CAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ldh enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83625","description":"Assay of ldh enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Integra flowable wound matri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4114","description":"Integra flowable wound matri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA33","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9017","description":"Amantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med trng & support per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0034","description":"Med trng & support per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB1","description":"ICD-FHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0867T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65260","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB156","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54120","description":"Partial removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB1","description":"ICD-BDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB0","description":"ICD-ICBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID1","description":"ICD-ADID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5263","description":"Hearing aid_ disp_ binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC0","description":"ICD-JHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA0","description":"ICD-EGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0542U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","description":"CPT-0542U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE124","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE1","description":"ICD-GARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE0","description":"ICD-FEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE0","description":"ICD-ECEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96932","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Combination oral/nasal mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7027","description":"Combination oral/nasal mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD0","description":"ICD-GAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA1","description":"ICD-BDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC0","description":"ICD-KIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00848","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","description":"CPT-00848","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED1","description":"ICD-CAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD0","description":"ICD-NIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens/es other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2599","description":"Contact lens/es other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD1","description":"ICD-JEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph fundoplasty thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43328","description":"Esoph fundoplasty thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF0","description":"ICD-OIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagenase_ clost hist inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0775","description":"Collagenase_ clost hist inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302T","description":"Icar ischm mntrng sys compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA0","description":"ICD-CEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC1","description":"ICD-OFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Refill/maint portable pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96521","description":"Refill/maint portable pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA0","description":"ICD-NJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE0","description":"ICD-MILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD0","description":"ICD-KAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB0","description":"ICD-GCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF0","description":"ICD-FBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA0","description":"ICD-NKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous blood op salvage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86891","description":"Autologous blood op salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB22","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC0","description":"ICD-BHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health club membership yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9970","description":"Health club membership yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC1","description":"ICD-GBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA1","description":"ICD-BHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA1","description":"ICD-DGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF0","description":"ICD-GISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA0","description":"ICD-FCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8687","description":"Implt nrostm pls gen dua rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB234","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8C","description":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND0","description":"ICD-FBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5258","description":"Hearing aid_ digit_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD0","description":"ICD-DDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC1","description":"ICD-ODNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23455","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp remove forgn body duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43275","description":"Ercp remove forgn body duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1574","description":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF0","description":"ICD-HHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94015","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc_ frz/deg/wsh_ l/r_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9057","description":"Rbc_ frz/deg/wsh_ l/r_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD0","description":"ICD-NEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE0","description":"ICD-CHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Image not std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9319","description":"Image not std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1>=risk or>= mod risk for te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8972","description":"1>=risk or>= mod risk for te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX23","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA1","description":"ICD-FEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF1","description":"ICD-NFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA1","description":"ICD-KEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC1","description":"ICD-OJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artificial larynx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8500","description":"Artificial larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49656","description":"Lap inc hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE1","description":"ICD-NFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF0","description":"ICD-KCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC1","description":"ICD-EECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF1","description":"ICD-MBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inirs each vessel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205T","description":"Inirs each vessel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE0","description":"ICD-IAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF1","description":"ICD-OGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF0","description":"ICD-NGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete phys skin exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2029F","description":"Complete phys skin exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB1","description":"ICD-OJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40842","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63075","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB1","description":"ICD-MJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7509","description":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube plug/stop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7527","description":"Trach/laryn tube plug/stop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inner ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69949","description":"Inner ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31370","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil two surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2420","description":"Dental gold foil two surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND1","description":"ICD-NKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE0","description":"ICD-BBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51820","description":"Revision of urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB0","description":"ICD-AGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC117","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ethylene glycol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82693","description":"Assay of ethylene glycol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Adaptations (>$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0141","description":"Home Adaptations (>$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC0","description":"ICD-BHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create passage to kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52334","description":"Create passage to kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB0","description":"ICD-CINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA0","description":"ICD-OEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9293","description":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66160","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD1","description":"ICD-OJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj intercost sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64420","description":"N block inj intercost sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB31","description":"ICD-4GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot s free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85306","description":"Clot inhibit prot s free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74170","description":"Ct abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath insertion tray w/bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4354","description":"Cath insertion tray w/bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA1","description":"ICD-GDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99315","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD0","description":"ICD-BHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230U","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 29-31 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2266","description":"Induced abortion 29-31 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE1","description":"ICD-KERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht pharm per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9810","description":"Ht pharm per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB1","description":"ICD-MBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC0","description":"ICD-OIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA1","description":"ICD-IFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0056U","description":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC1","description":"ICD-JFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22224","description":"Incis w/discectomy lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE1","description":"ICD-GCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD1","description":"ICD-IBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL11","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC0","description":"ICD-CHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF0","description":"ICD-BGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA1","description":"ICD-FDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB1","description":"ICD-CDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0631T","description":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0012","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD144","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF1","description":"ICD-NGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD0","description":"ICD-CARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB0","description":"ICD-HFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB1","description":"ICD-IDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp animat ret imag series","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380T","description":"Comp animat ret imag series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE1","description":"ICD-BIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC0","description":"ICD-OCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE0","description":"ICD-GIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD246","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dil retina exam interp rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2022F","description":"Dil retina exam interp rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage board postural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0606","description":"Drainage board postural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51720","description":"Treatment of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB0","description":"ICD-GFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28280","description":"Fusion of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA1","description":"ICD-GDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE0","description":"ICD-OAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bekesy audiometry screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92560","description":"Bekesy audiometry screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB0","description":"ICD-CDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2806","description":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB1","description":"ICD-JCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens pmma spherical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2500","description":"Contact lens pmma spherical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc bla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51999","description":"Laparoscope proc bla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF1","description":"ICD-FAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE0","description":"ICD-PFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF1","description":"ICD-ICUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA0","description":"ICD-OCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thaw preserved stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38208","description":"Thaw preserved stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shock absorber for power w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1016","description":"Shock absorber for power w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF1","description":"ICD-AGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0523","description":"Management of a new patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB1","description":"ICD-CDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urea-n clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84545","description":"Urea-n clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD1","description":"ICD-JCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5783","description":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC0","description":"ICD-NCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD1","description":"ICD-OLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77412","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31243","description":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Node neg inv brst cncr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8879","description":"Node neg inv brst cncr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11624","description":"Exc s/n/h/f/g mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF0","description":"ICD-FEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA0","description":"ICD-OEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29705","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD0","description":"ICD-KEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF0","description":"ICD-NDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE0","description":"ICD-GGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE0","description":"ICD-CCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE0","description":"ICD-EGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transport portable x-ray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0070","description":"Transport portable x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE1","description":"ICD-BBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ewho w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3764","description":"Ewho w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro sin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9607","description":"Perc d-e cor revasc chro sin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cognitive test by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96125","description":"Cognitive test by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD1","description":"ICD-DGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE0","description":"ICD-AHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Devise bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44316","description":"Devise bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC0","description":"ICD-GGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0647U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0647U","description":"CPT-0647U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdomen vessel surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88051","description":"Anesth abdomen vessel surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB1","description":"ICD-CCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF0","description":"ICD-OIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD1","description":"ICD-CHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0894T","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB0","description":"ICD-NGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear high roll cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2550","description":"Thigh/wght bear high roll cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB1","description":"ICD-FGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD1","description":"ICD-PFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36560","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND1","description":"ICD-OKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE217","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86619","description":"Borrelia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA1","description":"ICD-OLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE1","description":"ICD-FEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2630","description":"Cath_ ep_ cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medroxyprogesterone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1050","description":"Medroxyprogesterone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD1","description":"ICD-JCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE1","description":"ICD-OHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0441","description":"Stationary o2 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57305","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD0","description":"ICD-FCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB0","description":"ICD-MGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD0","description":"ICD-MGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ptnot rcvng anti-rhm thxpyra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4196F","description":"Ptnot rcvng anti-rhm thxpyra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD1","description":"ICD-CGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE140","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD1","description":"ICD-LDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE1","description":"ICD-NAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC0","description":"ICD-JDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD1","description":"ICD-CCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy for aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31515","description":"Laryngoscopy for aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB0","description":"ICD-NCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB0","description":"ICD-GBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA1","description":"ICD-BGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0558U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","description":"CPT-0558U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC1","description":"ICD-KBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB1","description":"ICD-EDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj multihance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9577","description":"Inj multihance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA1","description":"ICD-FCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15933","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB11","description":"ICD-2BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee pt noelg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8649","description":"Fun stat score knee pt noelg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF1","description":"ICD-FCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC0","description":"ICD-CDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD113","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF1","description":"ICD-FDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE0","description":"ICD-GGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE0","description":"ICD-NKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC0","description":"ICD-CHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26615","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE1","description":"ICD-NBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB0","description":"ICD-OHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD1","description":"ICD-BACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95978","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes alg risk recr urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013M","description":"ONC MRNA 5 genes alg risk recr urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE1","description":"ICD-MCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0578T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert electrd/pm cath sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33210","description":"Insert electrd/pm cath sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB0","description":"ICD-KDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2D","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF0","description":"ICD-BHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22830","description":"Exploration of spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC0","description":"ICD-FAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye glass case","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2756","description":"Eye glass case","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA1","description":"ICD-GAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vte prophylaxis rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4069F","description":"Vte prophylaxis rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB1","description":"ICD-FDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0791","description":"Injection_ crizanlizumab-tmca_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7040","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE1","description":"ICD-AGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 2 res","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014A","description":"Fee covid-19 vac 2 res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c >/= 130 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3050F","description":"Ldl-c >/= 130 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE1","description":"ICD-KFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA1","description":"ICD-NHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB1","description":"ICD-KFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Donor serv ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4025","description":"Donor serv ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lockingelbow forearm cntrbal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6693","description":"Lockingelbow forearm cntrbal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0491U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","description":"CPT-0491U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil prevoc waiver_ per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2014","description":"Habil prevoc waiver_ per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB0","description":"ICD-OEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD0","description":"ICD-PDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC0","description":"ICD-JFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD1","description":"ICD-FELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND1","description":"ICD-CEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA0","description":"ICD-BHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97151","description":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28112","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tandem cuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53444","description":"Insert tandem cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ionm in operatng room 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95940","description":"Ionm in operatng room 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6556","description":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA0","description":"ICD-KCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remv/repl penis contain pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54416","description":"Remv/repl penis contain pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME0","description":"ICD-ECME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE1","description":"ICD-HHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77600","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB1","description":"ICD-MAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF0","description":"ICD-NGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15936","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF0","description":"ICD-CFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID1","description":"ICD-CEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible diffuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87181","description":"Microbe susceptible diffuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene known variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81303","description":"Mecp2 gene known variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental sedative filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2940","description":"Dental sedative filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED0","description":"ICD-KIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E2513","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","description":"HCPCS-E2513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF0","description":"ICD-GGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD1","description":"ICD-OAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE0","description":"ICD-JFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Betadine/iodine swabs/wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4247","description":"Betadine/iodine swabs/wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40814","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC1","description":"ICD-GAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC0","description":"ICD-KHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA0","description":"ICD-JFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF0","description":"ICD-OLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB0","description":"ICD-JBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7525","description":"Tracheostomy mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HER2-targeted therapies administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9828","description":"HER2-targeted therapies administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD0","description":"ICD-DDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7517","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF0","description":"ICD-MICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC141","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC1","description":"ICD-CFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA0","description":"ICD-NHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA1","description":"ICD-PJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78608","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99282","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA26","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4369","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","description":"HCPCS-Q4369","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB31","description":"ICD-4AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92519","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA0","description":"ICD-KDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF1","description":"ICD-MGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA1","description":"ICD-EETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facial replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5929","description":"Facial replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC0","description":"ICD-BGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB1","description":"ICD-MGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone sinus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1090","description":"Mometasone sinus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD1","description":"ICD-FIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA1","description":"ICD-NCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA1","description":"ICD-GGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA1","description":"ICD-NEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9301","description":"HCPCS-C9301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD0","description":"ICD-EEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta non esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0888","description":"Epoetin beta non esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB0","description":"ICD-KGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA0","description":"ICD-ACHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of oxalate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83945","description":"Assay of oxalate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA0","description":"ICD-JIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC0","description":"ICD-NDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME0","description":"ICD-KAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics/Gynecology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4018","description":"Obstetrics/Gynecology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9261","description":"Doc surv no stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn for catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9239","description":"Docrsn for catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip flex inner socket ext fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5643","description":"Hip flex inner socket ext fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66852","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB1","description":"ICD-JGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF1","description":"ICD-FEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum over 10 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49205","description":"Exc abd tum over 10 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cont intraop neuro monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0453","description":"Cont intraop neuro monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE1","description":"ICD-OLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metalic 1 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2510","description":"Dental inlay metalic 1 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA1","description":"ICD-GHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA1","description":"ICD-FCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73723","description":"MRI joint lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB1","description":"ICD-HFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA0","description":"ICD-GEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE1","description":"ICD-JEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum 5 cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49203","description":"Exc abd tum 5 cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF1","description":"ICD-GFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64866","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy thru stoma spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44388","description":"Colonoscopy thru stoma spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6120","description":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD0","description":"ICD-OIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE1","description":"ICD-OHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA0","description":"ICD-BAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze>16<=48 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6217","description":"Non-sterile gauze>16<=48 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF1","description":"ICD-KDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph fundoplasty lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43327","description":"Esoph fundoplasty lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC1","description":"ICD-DCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42830","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA05","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE1","description":"ICD-BCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce/graft eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67255","description":"Reinforce/graft eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB0","description":"ICD-FCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rocker bottom_ contact afo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2232","description":"Rocker bottom_ contact afo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot lamin/prepreg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3031","description":"Foot lamin/prepreg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging 3 phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78315","description":"Bone imaging 3 phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE1","description":"ICD-NEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1608","description":"HCPCS-C1608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dicyclomine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0500","description":"Dicyclomine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99484","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0625U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","description":"CPT-0625U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE1","description":"ICD-GDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB0","description":"ICD-NDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD1","description":"ICD-IICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA1","description":"ICD-BHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC1","description":"ICD-FHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC21","description":"ICD-1KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0511U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","description":"CPT-0511U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prostate prob score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010M","description":"Onc prostate prob score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hair trnspl >15 punch grafts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15776","description":"Hair trnspl >15 punch grafts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0535U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","description":"CPT-0535U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Misc integral lens serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0590","description":"Misc integral lens serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29871","description":"Knee arthroscopy/drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB0","description":"ICD-DGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE0","description":"ICD-OGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE1","description":"ICD-ADIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD1","description":"ICD-CFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC0","description":"ICD-OFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infiltration of sustained release therapeutic drug - single or multiple sites","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9613","description":"Infiltration of sustained release therapeutic drug - single or multiple sites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shank ft w vert load pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5987","description":"Shank ft w vert load pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA0","description":"ICD-JCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21184","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE1","description":"ICD-LGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE0","description":"ICD-GCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 antigen lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81374","description":"Hla i typing 1 antigen lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1303","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC21","description":"ICD-3AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD0","description":"ICD-IECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine incon characterized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1091F","description":"Urine incon characterized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA0","description":"ICD-HGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1005T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","description":"CPT-1005T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF1","description":"ICD-OLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND0","description":"ICD-NLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA1","description":"ICD-OJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77089","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45900","description":"Reduction of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67311","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA51","description":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracranial bilat study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93880","description":"Extracranial bilat study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC1","description":"ICD-MLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90689","description":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE0","description":"ICD-KFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection jaw joint x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21116","description":"Injection jaw joint x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC1","description":"ICD-IFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0841T","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess negative docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3341F","description":"Mammo assess negative docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC1","description":"ICD-AFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB1","description":"ICD-OEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC0","description":"ICD-JBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE0","description":"ICD-GBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7700","description":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine documented as administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1064","description":"Shingrix vaccine documented as administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phakic iol refractive error","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0596","description":"Phakic iol refractive error","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD1","description":"ICD-KGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9340","description":"Hit enteral per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB1","description":"ICD-CBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC0","description":"ICD-NCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE1","description":"ICD-GIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB0","description":"ICD-NLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us < 14 wks single fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76801","description":"Ob us < 14 wks single fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB1","description":"ICD-JETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA31","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB0","description":"ICD-HDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19357","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC0","description":"ICD-BAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD0","description":"ICD-HGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 11-12 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95912","description":"Nrv cndj test 11-12 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD1","description":"ICD-OAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC0","description":"ICD-JAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB0","description":"ICD-JDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradj d-dimer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85380","description":"Fibrin degradj d-dimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC0","description":"ICD-FBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental unspec restorative pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2999","description":"Dental unspec restorative pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test cran nerv unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95867","description":"Muscle test cran nerv unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD1","description":"ICD-FGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE0","description":"ICD-IADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ apadamtase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9167","description":"Injection_ apadamtase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61583","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8X","description":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB0","description":"ICD-BCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8G","description":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA31","description":"ICD-2IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD1","description":"ICD-MIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA1","description":"ICD-ABAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69840","description":"Revise inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE0","description":"ICD-LGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC1","description":"ICD-OLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE1","description":"ICD-GIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual diff wbc count b-coat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85009","description":"Manual diff wbc count b-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93291","description":"Ilr device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1088","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj unspecified therapy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7899","description":"Tmj unspecified therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp prob addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87503","description":"Influenza dna amp prob addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57020","description":"Drainage of pelvic fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1488","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","description":"HCPCS-M1488","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4357","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","description":"HCPCS-Q4357","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE1","description":"ICD-JGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81111","description":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF1","description":"ICD-ECTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paricalcitol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2501","description":"Paricalcitol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF0","description":"ICD-OLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE154","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA1","description":"ICD-JDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD1","description":"ICD-OHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ intravas ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1753","description":"Cath_ intravas ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of elbow bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24105","description":"Removal of elbow bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8004","description":"HCPCS-C8004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC0","description":"ICD-KBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB1","description":"ICD-OLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC1","description":"ICD-ECDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chore services per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5121","description":"Chore services per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2114","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6535","description":"Gc stocking thighlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC0","description":"ICD-NACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81295","description":"Msh2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB145","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78122","description":"Blood volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE0","description":"ICD-DEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB0","description":"ICD-OCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54900","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Review patient spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94016","description":"Review patient spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF1","description":"ICD-BADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA0","description":"ICD-CIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0291","description":"Hosp bed fx ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/o pat by phys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99367","description":"Team conf w/o pat by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymph system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78195","description":"Lymph system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7543","description":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA0","description":"ICD-JDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC1","description":"ICD-FGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97172","description":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC1","description":"ICD-GCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD0","description":"ICD-CCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE0","description":"ICD-NBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC0","description":"ICD-MATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB1","description":"ICD-NACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF1","description":"ICD-FAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB1","description":"ICD-NIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Statin presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9441","description":"Statin presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31620","description":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262T","description":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace non-molded thigh lac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4045","description":"Replace non-molded thigh lac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD0","description":"ICD-MLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC0","description":"ICD-OKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF0","description":"ICD-FBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4D","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC1","description":"ICD-PISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC1","description":"ICD-DBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB0","description":"ICD-HIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB0","description":"ICD-JCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dimethyl sulfoxide 50% 50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1212","description":"Dimethyl sulfoxide 50% 50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programmer for transient_ orally ingested capsule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9268","description":"Programmer for transient_ orally ingested capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78647","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12042","description":"Intmd rpr n-hf/genit2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sialic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84275","description":"Assay of sialic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF0","description":"ICD-GGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE1","description":"ICD-MJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE1","description":"ICD-AFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC1","description":"ICD-JIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5052","description":"Clsd ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA0","description":"ICD-KDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF0","description":"ICD-EBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect neck thorax tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21557","description":"Resect neck thorax tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of calcium deposits","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23000","description":"Removal of calcium deposits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34713","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF1","description":"ICD-KFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC1","description":"ICD-OEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339U","description":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj menotropins 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0122","description":"Inj menotropins 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration femoral artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35721","description":"Exploration femoral artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE0","description":"ICD-ACDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF1","description":"ICD-KEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Single energy x-ray study","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0130","description":"Single energy x-ray study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8H","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF1","description":"ICD-LDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gloves","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4927","description":"Non-sterile gloves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB0","description":"ICD-OHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF1","description":"ICD-OBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0728T","description":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD1","description":"ICD-MHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35251","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26135","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC1","description":"ICD-NFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC1","description":"ICD-LEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC1","description":"ICD-MKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11443","description":"Exc face-mm b9+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID0","description":"ICD-MGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74280","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE0","description":"ICD-CHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amobarbital 125 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0300","description":"Amobarbital 125 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8B","description":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME1","description":"ICD-MJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA21","description":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57520","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA1","description":"ICD-PJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gene test sickle cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3850","description":"Gene test sickle cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cadaver donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50300","description":"Remove cadaver donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafix plus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4304","description":"Grafix plus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB1","description":"ICD-NFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57513","description":"Laser surgery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA1","description":"ICD-KGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1305","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB225","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE1","description":"ICD-CESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9192","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9192","description":"HCPCS-J9192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37220","description":"Iliac revasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef spec metabolic noninherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4154","description":"Ef spec metabolic noninherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC0","description":"ICD-CFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31085","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21243","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD1","description":"ICD-NHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung function test (mbc/mvv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94200","description":"Lung function test (mbc/mvv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295U","description":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED0","description":"ICD-OGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF1","description":"ICD-JHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32667","description":"Thoracoscopy w/w resect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC1","description":"ICD-KEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC0","description":"ICD-JEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA1","description":"ICD-JELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC1","description":"ICD-EFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF1","description":"ICD-NBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco-use counsel 3-10 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0436","description":"Tobacco-use counsel 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF0","description":"ICD-CFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE0","description":"ICD-JHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF0","description":"ICD-GDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB112","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54220","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20920","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94668","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewings four films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0274","description":"Dental bitewings four films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27509","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11302","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC0","description":"ICD-NHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB0","description":"ICD-CDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place stereo cath brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169T","description":"Place stereo cath brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE0","description":"ICD-NEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Macroscopic exam parasite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87169","description":"Macroscopic exam parasite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA1","description":"ICD-GHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46607","description":"Diagnostic anoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB1","description":"ICD-CIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB0","description":"ICD-KBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shorten radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25390","description":"Shorten radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD0","description":"ICD-FDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD1","description":"ICD-KIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA0","description":"ICD-JDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone replce graft each add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4264","description":"Bone replce graft each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC0","description":"ICD-GFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43631","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43291","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA1","description":"ICD-BDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA0","description":"ICD-IBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB0","description":"ICD-LHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC1","description":"ICD-MKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE1","description":"ICD-CEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA0","description":"ICD-OEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert endovasc prosth taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33883","description":"Insert endovasc prosth taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1122","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE1","description":"ICD-EGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Locm 200-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9966","description":"Locm 200-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impression casting ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0395","description":"Impression casting ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB1","description":"ICD-LDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84560","description":"Assay of urine/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0545U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","description":"CPT-0545U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF0","description":"ICD-LDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB1","description":"ICD-KCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9777","description":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA1","description":"ICD-NBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6522","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30460","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1905","description":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA1","description":"ICD-DBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67320","description":"Revise eye muscle(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC0","description":"ICD-CGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME1","description":"ICD-CAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA1","description":"ICD-NLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g._ inadequate prep_ familial or personal history of colonic polyps_ patient h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9862","description":"Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g._ inadequate prep_ familial or personal history of colonic polyps_ patient h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE0","description":"ICD-CAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD1","description":"ICD-KDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234U","description":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB1","description":"ICD-NDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE0","description":"ICD-KEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB0","description":"ICD-KGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC11","description":"ICD-2CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB0","description":"ICD-CGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB1","description":"ICD-KAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4649","description":"Surgical supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF1","description":"ICD-KGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF1","description":"ICD-JEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD0","description":"ICD-KERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8H","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31825","description":"Repair of windpipe defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA1","description":"ICD-GGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD0","description":"ICD-OBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB1","description":"ICD-EECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA0","description":"ICD-MKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86551","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","description":"HCPCS-L6030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9995","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symp aaa urgent repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9600","description":"Symp aaa urgent repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC02","description":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475U","description":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21179","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE1","description":"ICD-PAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF0","description":"ICD-MFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB1","description":"ICD-IBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9942","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD0","description":"ICD-FIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF1","description":"ICD-OKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD0","description":"ICD-OACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA1","description":"ICD-JFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB0","description":"ICD-BCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD1","description":"ICD-GGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50980","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31629","description":"Bronchoscopy/needle bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8I","description":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQB1","description":"ICD-KCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC0","description":"ICD-MIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove middle ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69676","description":"Remove middle ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX10","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD1","description":"ICD-KHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB136","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7553","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB1","description":"ICD-ICAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect prox finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26260","description":"Resect prox finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC0","description":"ICD-GIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD1","description":"ICD-BFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD0","description":"ICD-HCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD1","description":"ICD-OJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA1","description":"ICD-DCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply hand/wrist cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29085","description":"Apply hand/wrist cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD0","description":"ICD-NIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit blood products diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9538","description":"Hit blood products diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging/studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78016","description":"Thyroid met imaging/studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77065","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA1","description":"ICD-ICBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE1","description":"ICD-DAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50432","description":"Plmt nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB1","description":"ICD-KCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF0","description":"ICD-PLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21436","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41130","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID1","description":"ICD-MGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1010","description":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94070","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA1","description":"ICD-NAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB0","description":"ICD-CENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD1","description":"ICD-FDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA0","description":"ICD-OFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD240","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93228","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing id_ digit_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5254","description":"Hearing id_ digit_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6504","description":"Cmprsburngarment glove-wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA0","description":"ICD-EIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1302","description":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD0","description":"ICD-OCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1332","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA1","description":"ICD-CGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup exi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3620","description":"Trans shoe solid stirrup exi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD1","description":"ICD-KIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33465","description":"Replace tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF1","description":"ICD-BBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval amniotic fluid protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84112","description":"Eval amniotic fluid protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF0","description":"ICD-GHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA43","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15792","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE0","description":"ICD-GFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE0","description":"ICD-GGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of spine 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72020","description":"X-ray exam of spine 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD0","description":"ICD-FBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC0","description":"ICD-NBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6239","description":"Hydrocolld drg > 48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA1","description":"ICD-GFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27048","description":"Exc hip/pelv tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32656","description":"Thoracoscopy w/pleurectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0631","description":"Lso sag r an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD0","description":"ICD-IBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE0","description":"ICD-NBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD0","description":"ICD-KGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB33","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC0","description":"ICD-HIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supply/ext inf pump syr type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0552","description":"Supply/ext inf pump syr type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9534","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA1","description":"ICD-DHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA0","description":"ICD-FHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33340","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67974","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD1","description":"ICD-FACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF1","description":"ICD-GBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB1","description":"ICD-AIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF1","description":"ICD-IDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte phagocytosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86344","description":"Leukocyte phagocytosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC0","description":"ICD-NITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD0","description":"ICD-EBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0303","description":"HCPCS-A0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40500","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB1","description":"ICD-KCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8H","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Edetate calcium disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0600","description":"Edetate calcium disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA0","description":"ICD-OECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87533","description":"Hhv-6 dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath impl vasc access portal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4300","description":"Cath impl vasc access portal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33800","description":"Aortic suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5914","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC1","description":"ICD-OIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD1","description":"ICD-CHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC1","description":"ICD-CGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF1","description":"ICD-NKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doxorubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9000","description":"Doxorubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB1","description":"ICD-IEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB0","description":"ICD-FBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB0","description":"ICD-JCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27882","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC134","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8F","description":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME1","description":"ICD-OKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE0","description":"ICD-KFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC0","description":"ICD-LDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4239","description":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE0","description":"ICD-IIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC0","description":"ICD-KDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33030","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB1","description":"ICD-OAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB1","description":"ICD-GFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE0","description":"ICD-OLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF1","description":"ICD-OKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB0","description":"ICD-GGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC1","description":"ICD-JCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE1","description":"ICD-FBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA1","description":"ICD-OFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9054","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","description":"HCPCS-J9054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA0","description":"ICD-CEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No trnsfr from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582F","description":"No trnsfr from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE0","description":"ICD-EIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37788","description":"Revascularization penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436T","description":"Prgrmg eval npgs apnea study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44140","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity low","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3470F","description":"Ra disease activity low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE1","description":"ICD-JBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF1","description":"ICD-KGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC1","description":"ICD-OKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB0","description":"ICD-GEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB21","description":"ICD-4LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE0","description":"ICD-DHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE0","description":"ICD-KFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC1","description":"ICD-OAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/tumor excise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31640","description":"Bronchoscopy w/tumor excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB0","description":"ICD-EETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88154","description":"Cytopath c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB0","description":"ICD-BGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC0","description":"ICD-OKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone diacetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3302","description":"Triamcinolone diacetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF0","description":"ICD-NLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC1","description":"ICD-IIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA1","description":"ICD-CEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","description":"HCPCS-M1437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD1","description":"ICD-OLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reguard_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4255","description":"Reguard_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC1","description":"ICD-NDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gamma globulin > 10 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1560","description":"Gamma globulin > 10 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB0","description":"ICD-NHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA1","description":"ICD-FDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB0","description":"ICD-PCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert knee articulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5656","description":"Socket insert knee articulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9978","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB0","description":"ICD-JGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC1","description":"ICD-EBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF1","description":"ICD-BFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0119U","description":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC0","description":"ICD-KIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47556","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96120","description":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7532","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD1","description":"ICD-AGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB256","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF0","description":"ICD-JAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF1","description":"ICD-PLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abduct control hip semi-flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1630","description":"Abduct control hip semi-flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB1","description":"ICD-OFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0673","description":"Pressure pneum appl half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49188","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","description":"CPT-49188","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA0","description":"ICD-JAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23156","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81000","description":"Urinalysis nonauto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC0","description":"ICD-FFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB0","description":"ICD-JGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB1","description":"ICD-GFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81458","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC0","description":"ICD-OEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA1","description":"ICD-JFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment panty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6511","description":"Compres burn garment panty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4525","description":"Adult size pull-on sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE0","description":"ICD-CBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna antibody single strand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86226","description":"Dna antibody single strand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs uni 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71100","description":"X-ray exam ribs uni 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE1","description":"ICD-CCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA1","description":"ICD-DIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic aneurysm 5-5.4cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9002F","description":"Aortic aneurysm 5-5.4cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF0","description":"ICD-EFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE0","description":"ICD-OGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE1","description":"ICD-GGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB1","description":"ICD-BEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE1","description":"ICD-OBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB11","description":"ICD-4DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b lipid complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0287","description":"Amphotericin b lipid complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1011","description":"Family assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA251","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF0","description":"ICD-AAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB1","description":"ICD-CDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29891","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular reeducation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97112","description":"Neuromuscular reeducation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gluc monitor purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1030","description":"Gluc monitor purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef less than/equal to 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3055F","description":"Lvef less than/equal to 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE1","description":"ICD-NHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF1","description":"ICD-EFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF0","description":"ICD-OLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photosensitivity tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95056","description":"Photosensitivity tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD0","description":"ICD-LHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stnd wt frame power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0010","description":"Stnd wt frame power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA1","description":"ICD-CFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-position stnd fram sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0641","description":"Multi-position stnd fram sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC1","description":"ICD-NECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC1","description":"ICD-EFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC0","description":"ICD-GHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic myomectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58545","description":"Laparoscopic myomectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Canal prep/fitting of dowel","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3950","description":"Canal prep/fitting of dowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD0","description":"ICD-GHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47140","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain ovary abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58820","description":"Drain ovary abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE1","description":"ICD-KIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF1","description":"ICD-CDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE1","description":"ICD-CIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA0","description":"ICD-DFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA0","description":"ICD-LEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59510","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID1","description":"ICD-MJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB1","description":"ICD-NFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9897","description":"Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1028","description":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9351","description":"Doc >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB0","description":"ICD-KEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74320","description":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety counseling dementia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6101F","description":"Safety counseling dementia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spiro no perf or doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8926","description":"Spiro no perf or doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tob user recd cess interv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9458","description":"Tob user recd cess interv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB1","description":"ICD-MLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB1","description":"ICD-GDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF1","description":"ICD-OHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture type pulse field gel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87152","description":"Culture type pulse field gel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA1","description":"ICD-GDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0305","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0305","description":"CDT-D0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD151","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo w/o joint multi-axis an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2038","description":"Kafo w/o joint multi-axis an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA1","description":"ICD-FDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on eye; iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121U","description":"Anesthesia for procedures on eye; iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC1","description":"ICD-JDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF0","description":"ICD-NEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE0","description":"ICD-MAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC1","description":"ICD-JFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE0","description":"ICD-GDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF0","description":"ICD-HIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB0","description":"ICD-IABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6999","description":"Fixed prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Memory current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9168","description":"Memory current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF0","description":"ICD-OIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA1","description":"ICD-EHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2004","description":"HCPCS-A2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0204","description":"HCPCS-A0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE0","description":"ICD-BBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC0","description":"ICD-BINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Segmental pneumatic trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0656","description":"Segmental pneumatic trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31020","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr ampu fxd arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1170","description":"Whlchr ampu fxd arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB0","description":"ICD-GABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF1","description":"ICD-IDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","description":"HCPCS-A8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown full high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6790","description":"Crown full high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restorigin_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4192","description":"Restorigin_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF0","description":"ICD-GIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB1","description":"ICD-CHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Geriatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4008","description":"Geriatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB0","description":"ICD-MFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD0","description":"ICD-PGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC1","description":"ICD-MHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE1","description":"ICD-KCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lactation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9443","description":"Lactation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","description":"HCPCS-J1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD1","description":"ICD-CCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD241","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1525","description":"Remove bilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Min hd traum gcs=15 w/ct ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9530","description":"Min hd traum gcs=15 w/ct ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD1","description":"ICD-IEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 5-6 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98927","description":"Osteopath manj 5-6 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral occlusal film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0240","description":"Intraoral occlusal film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC112","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","description":"HCPCS-J9289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sputum specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89220","description":"Sputum specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA0","description":"ICD-GCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD0","description":"ICD-DARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF1","description":"ICD-OGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML32","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF1","description":"ICD-BBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1426","description":"Injection_ casimersen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD0","description":"ICD-FBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB220","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditory function 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92620","description":"Auditory function 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF1","description":"ICD-NBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC1","description":"ICD-NLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of spinal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64772","description":"Incision of spinal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair sternum/nuss w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21743","description":"Repair sternum/nuss w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE0","description":"ICD-JBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB0","description":"ICD-AILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA0","description":"ICD-MLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB221","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow adolescent myoelectron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7190","description":"Elbow adolescent myoelectron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB125","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND1","description":"ICD-CDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","description":"HCPCS-M1431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF1","description":"ICD-LBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC1","description":"ICD-GHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA0","description":"ICD-MAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF1","description":"ICD-FEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB0","description":"ICD-IGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close bronchial fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32815","description":"Close bronchial fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB0","description":"ICD-BAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF1","description":"ICD-JBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4359","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","description":"HCPCS-Q4359","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD0","description":"ICD-NEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD1","description":"ICD-PBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC1","description":"ICD-OKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31292","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC1","description":"ICD-OBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF1","description":"ICD-DCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rotation wrst w/ cable lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6625","description":"Rotation wrst w/ cable lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF0","description":"ICD-FFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID0","description":"ICD-KDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0A","description":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28730","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99427","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE1","description":"ICD-AIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC0","description":"ICD-JAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD0","description":"ICD-BIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE0","description":"ICD-MHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD1","description":"ICD-IFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB1","description":"ICD-KFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefotetan disodiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0074","description":"Injection_ cefotetan disodiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID1","description":"ICD-ICID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9994","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flexhd/allopatchhd/matrixhd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4128","description":"Flexhd/allopatchhd/matrixhd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2003","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90912","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76946","description":"Echo guide for amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3514F","description":"Hep c scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA1","description":"ICD-AIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gel pressure mattress pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0185","description":"Gel pressure mattress pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB0","description":"ICD-IGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune rheumatoid arthr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81490","description":"Autoimmune rheumatoid arthr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0303","description":"HCPCS-C0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF1","description":"ICD-NDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD0","description":"ICD-NCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disease progn ra poor docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3475F","description":"Disease progn ra poor docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA01","description":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF0","description":"ICD-GGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove blood clot from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65930","description":"Remove blood clot from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9058","description":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt asst re end life issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4553F","description":"Pt asst re end life issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD0","description":"ICD-JDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE0","description":"ICD-GBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF1","description":"ICD-BEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA23","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47780","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0789T","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27429","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA1","description":"ICD-OBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE155","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE1","description":"ICD-PBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj testosterone cypionate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1071","description":"Inj testosterone cypionate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE113","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD1","description":"ICD-GDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral rf treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53860","description":"Transurethral rf treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX43","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco-use counsel>10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0437","description":"Tobacco-use counsel>10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA234","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calibrated microcap tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4651","description":"Calibrated microcap tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA36","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE0","description":"ICD-CHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD0","description":"ICD-OIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD1","description":"ICD-AICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE0","description":"ICD-CIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs cran les simple addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61797","description":"Srs cran les simple addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX56","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Episiotomy or vaginal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59300","description":"Episiotomy or vaginal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD0","description":"ICD-BBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion 2 or more 3d images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0395","description":"Fusion 2 or more 3d images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC0","description":"ICD-FACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0707","description":"Intraoral - periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00216","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","description":"CPT-00216","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF0","description":"ICD-NBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_phys coor-care ovrsght","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9008","description":"Mccd_phys coor-care ovrsght","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB1","description":"ICD-AFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9159","description":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC0","description":"ICD-JDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF1","description":"ICD-FGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE1","description":"ICD-KCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD1","description":"ICD-CHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73630","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC0","description":"ICD-NFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ft prosth multiaxial ankl/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5978","description":"Ft prosth multiaxial ankl/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB1","description":"ICD-GHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD204","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc surveillance for disease","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9052","description":"Onc surveillance for disease","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB1","description":"ICD-EIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE0","description":"ICD-GIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD1","description":"ICD-GEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA1","description":"ICD-GCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair stomach-bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43880","description":"Repair stomach-bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing serologic rh(d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86901","description":"Blood typing serologic rh(d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE1","description":"ICD-EIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD1","description":"ICD-NKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA0","description":"ICD-KCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF1","description":"ICD-CGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF0","description":"ICD-GAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0494U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","description":"CPT-0494U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC1","description":"ICD-MGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion segmental face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15781","description":"Dermabrasion segmental face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48145","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42810","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD0","description":"ICD-GAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66500","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB0","description":"ICD-OKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27715","description":"Revision of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB1","description":"ICD-NIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA0","description":"ICD-JEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB1","description":"ICD-GFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","description":"HCPCS-M1380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC1","description":"ICD-BFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Male condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4267","description":"Male condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22843","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd injection varices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43243","description":"Egd injection varices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC0","description":"ICD-BGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE0","description":"ICD-GCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC0","description":"ICD-MJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32608","description":"Thoracoscopy w/bx nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34718","description":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF0","description":"ICD-ECAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9973","description":"Extrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treponema pallidum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86780","description":"Treponema pallidum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maint drug infus cath per wk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4221","description":"Maint drug infus cath per wk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Furnsh initial orthosis only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1200","description":"Furnsh initial orthosis only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB1","description":"ICD-FCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB1","description":"ICD-DBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nash fibrosure(tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003M","description":"Nash fibrosure(tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA1","description":"ICD-KBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD1","description":"ICD-KDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB0","description":"ICD-LGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA1","description":"ICD-FCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8E","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA0","description":"ICD-DFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA1","description":"ICD-OHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE1","description":"ICD-MBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61531","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91304","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA241","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplt allo lymphocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38242","description":"Transplt allo lymphocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35216","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD1","description":"ICD-FEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC20","description":"High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23575","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC1","description":"ICD-BFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA0","description":"ICD-CHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0627U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","description":"CPT-0627U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1704","description":"HCPCS-B1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA1","description":"ICD-ABHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41114","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0234","description":"HCPCS-Q0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC0","description":"ICD-DGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA1","description":"ICD-MAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33265","description":"Ablate atria lmtd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Belatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0485","description":"Belatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL56","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE1","description":"ICD-OATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE0","description":"ICD-CEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF1","description":"ICD-OKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF1","description":"ICD-IITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD0","description":"ICD-NABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dextranomer/hyaluronic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8604","description":"Dextranomer/hyaluronic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bioimpedance cv analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93701","description":"Bioimpedance cv analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA0","description":"ICD-DIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB1","description":"ICD-CFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC1","description":"ICD-PAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE1","description":"ICD-PBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA1","description":"ICD-GIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA1","description":"ICD-AACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC0","description":"ICD-KGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bamlanivimab_ 700 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0239","description":"Bamlanivimab_ 700 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB1","description":"ICD-JIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA0","description":"ICD-DHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF0","description":"ICD-OAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16378","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16378","description":"CPT-16378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD0","description":"ICD-GEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE0","description":"ICD-LAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81234","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90481","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","description":"CPT-90481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2218","description":"Lens aniseikonic bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF0","description":"ICD-FINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE1","description":"ICD-KFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt pulse gen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4638","description":"Repl batt pulse gen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc hep gene risk classifier","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006M","description":"Onc hep gene risk classifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC134","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC1","description":"ICD-OBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9459","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF0","description":"ICD-MCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA0","description":"ICD-IHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB43","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD1","description":"ICD-MLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infliximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1745","description":"Infliximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA1","description":"ICD-OBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB1","description":"ICD-OCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of arm bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24140","description":"Partial removal of arm bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB0","description":"ICD-GHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB1","description":"ICD-JEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA1","description":"ICD-KEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF1","description":"ICD-CEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE1","description":"ICD-OHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD0","description":"ICD-KFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE1","description":"ICD-KGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraoral posterior image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0251","description":"Extraoral posterior image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF0","description":"ICD-OFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF0","description":"ICD-FBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63052","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA1","description":"ICD-ICEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD1","description":"ICD-PCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replant forearm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20805","description":"Replant forearm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC1","description":"ICD-JDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF0","description":"ICD-KBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD0","description":"ICD-FACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 20 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1020","description":"Methylprednisolone 20 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1062","description":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0750T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87496","description":"Cytomeg dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA0","description":"ICD-EFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sbrt delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77373","description":"Sbrt delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6574","description":"Gradient compression arm sleeve and glove combination_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pneumococcal admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8867","description":"No pneumococcal admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB1","description":"ICD-KGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD1","description":"ICD-ACLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF1","description":"ICD-HGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF0","description":"ICD-GAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE1","description":"ICD-NDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB0","description":"ICD-LIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33276","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF0","description":"ICD-BDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD0","description":"ICD-GFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC0","description":"ICD-MBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy adrenalectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60650","description":"Laparoscopy adrenalectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE0","description":"ICD-GFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB0","description":"ICD-AGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC1","description":"ICD-BBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA1","description":"ICD-KEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66605","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC1","description":"ICD-HFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF0","description":"ICD-FICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cushioned headrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0955","description":"Cushioned headrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5129","description":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB0","description":"ICD-NDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv hedia outpt dyls fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8956","description":"Pt rcv hedia outpt dyls fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA21","description":"ICD-3BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD0","description":"ICD-EDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lumbar hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49540","description":"Repair lumbar hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC0","description":"ICD-AEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB0","description":"ICD-BEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA0","description":"ICD-MJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0D","description":"Medium Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF0","description":"ICD-KBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41015","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit device repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5036","description":"Hit device repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam si joints 3/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72202","description":"X-ray exam si joints 3/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF1","description":"ICD-CCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xyntha inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7185","description":"Xyntha inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen crosslinks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82523","description":"Collagen crosslinks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB1","description":"ICD-NFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA1","description":"ICD-GCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD1","description":"ICD-BHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myringotomy laser-assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2225","description":"Myringotomy laser-assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exchange drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49423","description":"Exchange drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC0","description":"ICD-OAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF1","description":"ICD-GFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB0","description":"ICD-OLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81025","description":"Urine pregnancy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto fluid redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88175","description":"Cytopath c/v auto fluid redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adenovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86603","description":"Adenovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF1","description":"ICD-OAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF0","description":"ICD-AITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF1","description":"ICD-GFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC1","description":"ICD-OACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF0","description":"ICD-NIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flexible keel foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5972","description":"Flexible keel foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB0","description":"ICD-JHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA0","description":"ICD-NEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE125","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA1","description":"ICD-LGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC1","description":"ICD-GGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE0","description":"ICD-OEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB1","description":"ICD-ODYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58674","description":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC1","description":"ICD-GEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sugars single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84376","description":"Sugars single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","description":"HCPCS-M1387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA1","description":"ICD-EBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID1","description":"ICD-MCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES136","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA1","description":"ICD-PHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE1","description":"ICD-JIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346U","description":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC1","description":"ICD-CCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc cranial extra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61782","description":"Scan proc cranial extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IN GNOTYP CD44 EXONS 2 3 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191U","description":"IN GNOTYP CD44 EXONS 2 3 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mmr vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90707","description":"Mmr vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB1","description":"ICD-EGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML14","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF0","description":"ICD-JFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE1","description":"ICD-CAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moveable patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0639","description":"Moveable patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD1","description":"ICD-KFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ metronidazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0030","description":"Injection_ metronidazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE1","description":"ICD-KHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC1","description":"ICD-KADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cl mult vsd w/rem pul band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33677","description":"Cl mult vsd w/rem pul band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC1","description":"ICD-KDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD1","description":"ICD-FGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF1","description":"ICD-IBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1401","description":"CDT-D1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27570","description":"Fixation of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74480","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8C","description":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED1","description":"ICD-IHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA0","description":"ICD-OLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glucagon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82943","description":"Assay of glucagon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extra heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0007","description":"Extra heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stool collection pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4330","description":"Stool collection pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB0","description":"ICD-PLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB0","description":"ICD-CCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27435","description":"Incision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tongue nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64740","description":"Incision of tongue nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD0","description":"ICD-NLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE1","description":"ICD-OGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE0","description":"ICD-BAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csit lowrisk surg pts preop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8961","description":"Csit lowrisk surg pts preop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC0","description":"ICD-MCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF0","description":"ICD-ODGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD0","description":"ICD-BELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB0","description":"ICD-NFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inflammatory bowel dis mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8899","description":"Inflammatory bowel dis mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE0","description":"ICD-CGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","description":"HCPCS-E1034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB1","description":"ICD-KCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7677","description":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF1","description":"ICD-EGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB1","description":"ICD-LISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mech hip extension assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5855","description":"Mech hip extension assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7169","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF1","description":"ICD-BCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (Uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9158","description":"Injection_ risperidone_ (Uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9160","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD1","description":"ICD-JGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81112","description":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF1","description":"ICD-MBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB1","description":"ICD-OIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20600","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA1","description":"ICD-CCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD0","description":"ICD-JEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Current percep threshold tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0255","description":"Current percep threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB1","description":"ICD-EITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ldr prostate brachy comp rat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0458","description":"Ldr prostate brachy comp rat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90678","description":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0575U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","description":"CPT-0575U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63700","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB0","description":"ICD-MGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC44","description":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surg dx exam anorectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45990","description":"Surg dx exam anorectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF0","description":"ICD-OEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54440","description":"Repair of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB0","description":"ICD-AAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE0","description":"ICD-IEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Covers for upright each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1120","description":"Covers for upright each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF0","description":"ICD-EABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE1","description":"ICD-MBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit im injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99506","description":"Home visit im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54699","description":"Laparoscope proc testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF1","description":"ICD-GDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF1","description":"ICD-PIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human epididymis protein 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86305","description":"Human epididymis protein 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC1","description":"ICD-NJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD1","description":"ICD-BHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81121","description":"IDH2 (isocitrate dehydrogenase 2 [NADP+]_ mitochondrial) (eg_ glioma)_ common variants (eg_ R140W_ R172M)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD1","description":"ICD-GIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Miglustat_ oral_ 65 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1202","description":"Miglustat_ oral_ 65 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB0","description":"ICD-CDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Misc/exper non-prescript dru","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9150","description":"Misc/exper non-prescript dru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64555","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust elbow ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1800","description":"Adjust elbow ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC1","description":"ICD-FCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF0","description":"ICD-CCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA0","description":"ICD-JDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF1","description":"ICD-KAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD0","description":"ICD-IBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA1","description":"ICD-KHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE0","description":"ICD-NJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF0","description":"ICD-GBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE1","description":"ICD-EHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ceftizoxime sodium / 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0715","description":"Ceftizoxime sodium / 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; other source_ quantitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82042","description":"Albumin; other source_ quantitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap enterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44202","description":"Lap enterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE0","description":"ICD-KCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC1","description":"ICD-FFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC1","description":"ICD-DDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES355","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD1","description":"ICD-GDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB0","description":"ICD-JFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE0","description":"ICD-CCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7504","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA1","description":"ICD-BEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE0","description":"ICD-OGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prp i/hern init block >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49507","description":"Prp i/hern init block >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB1","description":"ICD-BIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD1","description":"ICD-DIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90969","description":"Esrd home pt srv p day 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total disc arthrp ant appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375T","description":"Total disc arthrp ant appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE0","description":"ICD-FGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immed max part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5223","description":"Immed max part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE1","description":"ICD-ODQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE0","description":"ICD-GGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE0","description":"ICD-FCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA1","description":"ICD-FGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hmes or trach valve housing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7505","description":"Hmes or trach valve housing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of multivisc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2054","description":"Transplantation of multivisc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD0","description":"ICD-ICMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA1","description":"ICD-JEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26372","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA0","description":"ICD-MLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6232","description":"Hydrogel dsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00562","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","description":"CPT-00562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No abd imag w/o reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9457","description":"No abd imag w/o reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O&p supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L9900","description":"O&p supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA0","description":"ICD-LDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection ext venography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36005","description":"Injection ext venography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD0","description":"ICD-PAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0599","description":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl zinc air battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8621","description":"Repl zinc air battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis w adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8031","description":"Breast prosthesis w adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 17-18 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP18","description":"Auto test panel pricing code_ 17-18 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD224","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB0","description":"ICD-NDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC1","description":"ICD-MLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9976","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB0","description":"ICD-MKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24073","description":"Ex arm/elbow tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB1","description":"ICD-BFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB246","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA0","description":"ICD-PBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD1","description":"ICD-EHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE1","description":"ICD-CGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1757","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1757","description":"HCPCS-J1757","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB0","description":"ICD-JFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME0","description":"ICD-EFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF1","description":"ICD-EGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31087","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC1","description":"ICD-JATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of abdominal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27100","description":"Transfer of abdominal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD0","description":"ICD-BCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB11","description":"ICD-1JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB0","description":"ICD-OLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD1","description":"ICD-BDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60500","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC1","description":"ICD-BDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy tube collar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7526","description":"Tracheostomy tube collar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20680","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID1","description":"ICD-BBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC1","description":"ICD-BHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA0","description":"ICD-PCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Torsion mechanism knee/ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2861","description":"Torsion mechanism knee/ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decoronation or submergence of an erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3921","description":"Decoronation or submergence of an erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC1","description":"ICD-MEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC1","description":"ICD-CCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4046F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE1","description":"ICD-ECLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mh svc plan dev by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0032","description":"Mh svc plan dev by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA1","description":"ICD-NDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Determines Patient Does Not Require Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0038","description":"Clinician Determines Patient Does Not Require Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA1","description":"ICD-GBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA0","description":"ICD-OBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold outsid lock hinge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6200","description":"Elbow mold outsid lock hinge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE0","description":"ICD-EHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF1","description":"ICD-FBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB1","description":"ICD-LBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE256","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33017","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC0","description":"ICD-KGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Idet single level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22526","description":"Idet single level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF0","description":"ICD-NCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB1","description":"ICD-IIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE1","description":"ICD-LHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 11-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99447","description":"Interprof phone/online 11-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF1","description":"ICD-LDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal orthotic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7880","description":"Occlusal orthotic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0496U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","description":"CPT-0496U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Twist drill hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61105","description":"Twist drill hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52325","description":"Cystoscopy stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD1","description":"ICD-BBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA0","description":"ICD-KAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD245","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67901","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42845","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA0","description":"ICD-CFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90750","description":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC1","description":"ICD-OBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abscess imaging ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78805","description":"Abscess imaging ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL43","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA0","description":"ICD-ADTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC0","description":"ICD-FFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6009","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0604","description":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA1","description":"ICD-HAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB260","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE1","description":"ICD-JHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0700","description":"Ctlso a-p-l control molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD0","description":"ICD-HBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF0","description":"ICD-FEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE1","description":"ICD-CDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA1","description":"ICD-GGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC0","description":"ICD-DIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA1","description":"ICD-CCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24530","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB35","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1704","description":"HCPCS-A1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66150","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD0","description":"ICD-HHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44403","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD0","description":"ICD-OJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dark adaptation eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92284","description":"Dark adaptation eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB116","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29582","description":"Apply multlay comprs upr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt nephroureteral catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50433","description":"Plmt nephroureteral catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc death after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9260","description":"Doc death after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF0","description":"ICD-ICCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC244","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64859","description":"Nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD0","description":"ICD-AIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC0","description":"ICD-BBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE1","description":"ICD-GILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84703","description":"Chorionic gonadotropin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00100","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","description":"CPT-00100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF1","description":"ICD-KHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8G","description":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65780","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44373","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9149","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC1","description":"ICD-PHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC0","description":"ICD-NAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB0","description":"ICD-AFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF1","description":"ICD-LAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD1","description":"ICD-KHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD0","description":"ICD-FDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF1","description":"ICD-GDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7523","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME1","description":"ICD-EGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB0","description":"ICD-NJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF1","description":"ICD-NIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","description":"HCPCS-J0616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB1","description":"ICD-PHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0652U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0652U","description":"CPT-0652U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0D","description":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC0","description":"ICD-NHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2004","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF1","description":"ICD-MKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC1","description":"ICD-JAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB1","description":"ICD-DGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43634","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB1","description":"ICD-IGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth insert penis device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93851","description":"Anesth insert penis device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF1","description":"ICD-JGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9128","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9128","description":"CDT-D9128","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78830","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF0","description":"ICD-KCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA1","description":"ICD-CIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC0","description":"ICD-EEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0514","description":"Disp fee inhal drugs/90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1501","description":"HCPCS-B1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1601","description":"HCPCS-C1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC0","description":"ICD-CIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Combo pegintf/rib rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4153F","description":"Combo pegintf/rib rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF0","description":"ICD-JCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5948","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5948","description":"CDT-D5948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infant safety class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9447","description":"Infant safety class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB13","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33975","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF0","description":"ICD-GBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE0","description":"ICD-NENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8E","description":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD0","description":"ICD-IGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00103","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","description":"CPT-00103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with pregnancy during adjuvant treatment course","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2205","description":"Patients with pregnancy during adjuvant treatment course","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF0","description":"ICD-BCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC11","description":"ICD-4CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31781","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace g-j tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49452","description":"Replace g-j tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No strk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8574","description":"No strk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA1","description":"ICD-KHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89258","description":"Cryopreservation embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD0","description":"ICD-MGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE0","description":"ICD-BBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bso omentectomy w/tah","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58956","description":"Bso omentectomy w/tah","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB1","description":"ICD-DEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 500 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4217","description":"Sterile water/saline_ 500 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID0","description":"ICD-NEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE1","description":"ICD-ABUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36251","description":"Ins cath ren art 1st unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62327","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Signature APatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4260","description":"Signature APatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5148","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","description":"HCPCS-Q5148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX01","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1044","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE0","description":"ICD-CEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86831","description":"Hla class ii phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC0","description":"ICD-BFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band >=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6449","description":"Lt compres band >=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo neurostim 1 array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61885","description":"Insrt/redo neurostim 1 array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn binaur hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5120","description":"Body-worn binaur hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA0","description":"ICD-IGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB31","description":"ICD-2IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0936T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","description":"CPT-0936T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF1","description":"ICD-PBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC213","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE1","description":"ICD-NJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE0","description":"ICD-NEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29355","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF1","description":"ICD-KEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99242","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA1","description":"ICD-KIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27488","description":"Removal of knee prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD1","description":"ICD-KGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB1","description":"ICD-OGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD0","description":"ICD-LHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA1","description":"ICD-KGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA1","description":"ICD-EBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9701","description":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87652","description":"Strep a dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9075","description":"Injection_ casimersen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0870T","description":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE0","description":"ICD-KFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0946T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","description":"CPT-0946T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB1","description":"ICD-OLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA0","description":"ICD-NCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB45","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA1","description":"ICD-FBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB0","description":"ICD-JGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA0","description":"ICD-GDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9773","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF0","description":"ICD-NBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo plastic molded w/ankle j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1970","description":"Afo plastic molded w/ankle j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for spleen x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38200","description":"Injection for spleen x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71275","description":"Ct angiography chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9368","description":"Hit tpn over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405U","description":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA1","description":"ICD-JIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC0","description":"ICD-EIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47555","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA1","description":"ICD-PFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE1","description":"ICD-PKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","description":"HCPCS-Q0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC1","description":"ICD-GADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0642","description":"Lo sag ri an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair leg fascia defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27656","description":"Repair leg fascia defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped hydrolyzed/amino acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4161","description":"Ef ped hydrolyzed/amino acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE1","description":"ICD-GHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB1","description":"ICD-MHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5107","description":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of precision att","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5867","description":"Replacement of precision att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF1","description":"ICD-OAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF1","description":"ICD-HAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82725","description":"Assay of blood fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC0","description":"ICD-NBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64657","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","description":"CPT-64657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ot evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97003","description":"Ot evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9944","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"L hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93459","description":"L hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6528","description":"Gradient compression garment_ bra_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25455","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE0","description":"ICD-ODRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical foods for noninborn errors of metabolism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9432","description":"Medical foods for noninborn errors of metabolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analyze sp inf pump w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62368","description":"Analyze sp inf pump w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB0","description":"ICD-NHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replc tth&acrlc mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5671","description":"Replc tth&acrlc mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE1","description":"ICD-GBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87467","description":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB0","description":"ICD-CGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB1","description":"ICD-OKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB1","description":"ICD-HCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC0","description":"ICD-JBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC0","description":"ICD-CFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Varicella-zoster antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86787","description":"Varicella-zoster antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin pinch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15050","description":"Skin pinch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE1","description":"ICD-OCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB0","description":"ICD-NLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF0","description":"ICD-MCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF1","description":"ICD-OKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61708","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE0","description":"ICD-LISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF1","description":"ICD-KIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE0","description":"ICD-OHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice long term care_ r&b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2046","description":"Hospice long term care_ r&b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87185","description":"Microbe susceptible enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70140","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sng solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2010","description":"Kafo sng solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF0","description":"ICD-NKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA0","description":"ICD-OCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20690","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appl multlay comprs arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29584","description":"Appl multlay comprs arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA0","description":"ICD-EDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In111 oxyquinoline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9547","description":"In111 oxyquinoline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nutrition/Dietician Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4017","description":"Nutrition/Dietician Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448U","description":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","description":"HCPCS-J2351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1275","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND1","description":"ICD-CCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9034","description":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF1","description":"ICD-KDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD1","description":"ICD-CBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE1","description":"ICD-KEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD1","description":"ICD-KHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE1","description":"ICD-CINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27454","description":"Realignment of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin splt grft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15100","description":"Skin splt grft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD1","description":"ICD-MJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov comp bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7240","description":"Impact tooth remov comp bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status performed once in the last 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9916","description":"Functional status performed once in the last 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29873","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF1","description":"ICD-OCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE0","description":"ICD-GAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC0","description":"ICD-CEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB1","description":"ICD-OBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arch supp att to shoe long/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3090","description":"Arch supp att to shoe long/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB1","description":"ICD-GFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrate iv infusion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96361","description":"Hydrate iv infusion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE0","description":"ICD-GHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61720","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","description":"HCPCS-J0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB0","description":"ICD-GGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA1","description":"ICD-BECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Card MRI veloc flow mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75565","description":"Card MRI veloc flow mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB0","description":"ICD-KGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB1","description":"ICD-IECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE1","description":"ICD-OJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB17","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81464","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Middle ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69799","description":"Middle ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2097","description":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB0","description":"ICD-JFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF1","description":"ICD-KFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4005","description":"Family Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB1","description":"ICD-PFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0805","description":"HCPCS-C0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0851T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB1","description":"ICD-BAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC0","description":"ICD-LFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD0","description":"ICD-HBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE1","description":"ICD-AEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA1","description":"ICD-JAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME0","description":"ICD-BIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB1","description":"ICD-JGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC0","description":"ICD-FABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA1","description":"ICD-IFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD1","description":"ICD-PKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9817","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9817","description":"HCPCS-C9817","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE1","description":"ICD-IHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC1","description":"ICD-CFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aurothioglucose injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2910","description":"Aurothioglucose injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5120","description":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC0","description":"ICD-OCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF1","description":"ICD-NKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","description":"CPT-01400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj ilio-ing/hypogi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64425","description":"N block inj ilio-ing/hypogi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB1","description":"ICD-PKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15820","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD0","description":"ICD-NLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC1","description":"ICD-MJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10011","description":"Fine needle aspiration biopsy_ including MR guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb thermopls molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5530","description":"Prep bk ptb thermopls molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159T","description":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis west eqne antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86654","description":"Encephaltis west eqne antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF1","description":"ICD-CAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC0","description":"ICD-DCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD1","description":"ICD-NBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF1","description":"ICD-HFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD1","description":"ICD-MIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF1","description":"ICD-JATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0402","description":"HCPCS-A0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF1","description":"ICD-BCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD1","description":"ICD-KHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC1","description":"ICD-BALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tens two lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0720","description":"Tens two lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Depo-estradiol cypionate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1000","description":"Depo-estradiol cypionate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA1","description":"ICD-MLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp >/= 140 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3077F","description":"Syst bp >/= 140 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52354","description":"Cystouretero w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Regadenoson injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2785","description":"Regadenoson injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38760","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF0","description":"ICD-OCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD0","description":"ICD-OCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA0","description":"ICD-KEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF0","description":"ICD-JBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC0","description":"ICD-JABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD0","description":"ICD-ABAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinic service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1015","description":"Clinic service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC111","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE1","description":"ICD-FCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB0","description":"ICD-KHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF1","description":"ICD-PIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB1","description":"ICD-CAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD0","description":"ICD-FAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA1","description":"ICD-NCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID1","description":"ICD-ACID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC1","description":"ICD-FFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4170","description":"Cygnus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC1","description":"ICD-NGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB1","description":"ICD-NHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB0","description":"ICD-OKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SHIGA-LIKE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87427","description":"IAAD IA SHIGA-LIKE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD0","description":"ICD-JAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA1","description":"ICD-NBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB1","description":"ICD-OBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF1","description":"ICD-JHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB45","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83721","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC0","description":"ICD-OBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7531","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal angioplasty with intravascular ultrasound (initial noncoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear mold/insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5264","description":"Ear mold/insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00918","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","description":"CPT-00918","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cold agglutinin titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86157","description":"Cold agglutinin titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF0","description":"ICD-OACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prism lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2715","description":"Prism lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1031","description":"Nonpneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC0","description":"ICD-CACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB1","description":"ICD-FDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl DualGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4332","description":"Axolotl DualGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing loss sequence analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81430","description":"Hearing loss sequence analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF0","description":"ICD-ODKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate oral 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8610","description":"Methotrexate oral 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/repair chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32110","description":"Explore/repair chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear localization/abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78807","description":"Nuclear localization/abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE1","description":"ICD-JGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB44","description":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0983T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","description":"CPT-0983T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2021","description":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA1","description":"ICD-NICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE0","description":"ICD-EACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home phototherapy visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9098","description":"Home phototherapy visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0D","description":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC1","description":"ICD-OHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA1","description":"ICD-GIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF0","description":"ICD-CINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of arm nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64861","description":"Repair of arm nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA1","description":"ICD-OBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytarabine hcl 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9100","description":"Cytarabine hcl 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deliver placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59414","description":"Deliver placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE0","description":"ICD-ADCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD1","description":"ICD-EFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA11","description":"ICD-4EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC0","description":"ICD-FEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","description":"HCPCS-Q4362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67413","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx id dilution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86976","description":"Rbc serum pretx id dilution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral bolus nurs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9343","description":"Hit enteral bolus nurs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr <=4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4407","description":"Ext wear ost skn barr <=4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC0","description":"ICD-GEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27457","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE1","description":"ICD-CCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF0","description":"ICD-CBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF1","description":"ICD-KAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC0","description":"ICD-KENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC1","description":"ICD-KCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE0","description":"ICD-OGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB0","description":"ICD-BGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC1","description":"ICD-CAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99348","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel sach cushion type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3450","description":"Shoe heel sach cushion type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA1","description":"ICD-OFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF1","description":"ICD-FIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0968T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","description":"CPT-0968T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA1","description":"ICD-EADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB0","description":"ICD-LCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB0","description":"ICD-FFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC0","description":"ICD-IBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01432","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","description":"CPT-01432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE0","description":"ICD-LDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE1","description":"ICD-PHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD1","description":"ICD-JAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA0","description":"ICD-OBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC1","description":"ICD-NHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automatic bp monitor_ dial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4670","description":"Automatic bp monitor_ dial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27766","description":"Optx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD1","description":"ICD-FAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF1","description":"ICD-CBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA0","description":"ICD-MFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE1","description":"ICD-EITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27818","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe styled positioning dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3160","description":"Shoe styled positioning dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE0","description":"ICD-KBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0656T","description":"Vertebral body tethering_ anterior; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0903","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA1","description":"ICD-DBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 3 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0602","description":"Repl batt silver oxide 3 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA0","description":"ICD-BDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93314","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"D5w/0.45ns w kcl and mgs04","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5014","description":"D5w/0.45ns w kcl and mgs04","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1833","description":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC1","description":"ICD-OIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA0","description":"ICD-BCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE0","description":"ICD-FHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF1","description":"ICD-DIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF0","description":"ICD-CBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD1","description":"ICD-KBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE0","description":"ICD-CCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF0","description":"ICD-KAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0657T","description":"Vertebral body tethering_ anterior; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF1","description":"ICD-CEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF1","description":"ICD-FELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rep perf anoper/vestib fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46716","description":"Rep perf anoper/vestib fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF0","description":"ICD-FIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC1","description":"ICD-BATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Systemic antimicrobials prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9961","description":"Systemic antimicrobials prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68020","description":"Incise/drain eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorax stereo rad targetw/tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32701","description":"Thorax stereo rad targetw/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable 02 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0443","description":"Portable 02 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB1","description":"ICD-FEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF1","description":"ICD-IBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE1","description":"ICD-GGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB1","description":"ICD-PJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX30","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD1","description":"ICD-GHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC0","description":"ICD-JIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2B","description":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB1","description":"ICD-NHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vasectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92151","description":"Anesth vasectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC0","description":"ICD-BGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2C","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special radiation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77470","description":"Special radiation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83516","description":"Immunoassay nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB0","description":"ICD-OHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID0","description":"ICD-CHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein any source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84160","description":"Assay of protein any source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81247","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15793","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8680","description":"Orthodontic retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2787","description":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA0","description":"ICD-KEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0205","description":"HCPCS-B0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC0","description":"ICD-GDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC0","description":"ICD-OATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE0","description":"ICD-KGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB21","description":"ICD-1HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9285","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF0","description":"ICD-NLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD1","description":"ICD-GBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB0","description":"ICD-OHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit wound care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9097","description":"Home visit wound care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC0","description":"ICD-JBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell count <200cells/mm3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3494F","description":"Cd4+cell count <200cells/mm3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA0","description":"ICD-OGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD1","description":"ICD-JBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397U","description":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85611","description":"Prothrombin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/graph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47563","description":"Laparo cholecystectomy/graph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE0","description":"ICD-NIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD0","description":"ICD-GAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compressor nondispos filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7014","description":"Compressor nondispos filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA1","description":"ICD-OJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC21","description":"ICD-3GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull repair/fract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21551","description":"Anesth skull repair/fract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB0","description":"ICD-MKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4316","description":"Cath w/drainage 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29881","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Japanese encephalitis virus vaccine_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90735","description":"Japanese encephalitis virus vaccine_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC0","description":"ICD-KFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC1","description":"ICD-HBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC0","description":"ICD-KAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86774","description":"Tetanus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81427","description":"Genome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vertebroplasty addl inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22512","description":"Vertebroplasty addl inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX55","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD0","description":"ICD-KAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0893T","description":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA0","description":"ICD-OBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE0","description":"ICD-AITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF1","description":"ICD-PAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME0","description":"ICD-OIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57550","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA1","description":"ICD-HHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7506","description":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlorothiazide sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1205","description":"Chlorothiazide sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB41","description":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61863","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE0","description":"ICD-ADHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj cutting into joint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7860","description":"Tmj cutting into joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB1","description":"ICD-BGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF0","description":"ICD-OIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF1","description":"ICD-OLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD0","description":"ICD-FBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2101","description":"CDT-D2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB0","description":"ICD-MGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE0","description":"ICD-CCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC0","description":"ICD-CHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC1","description":"ICD-HCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB0","description":"ICD-GFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay caffeine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80155","description":"Drug assay caffeine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert i-aort percut device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33967","description":"Insert i-aort percut device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1011","description":"Clinical Decision Support Mechanism_ Qualified Tool Not Otherwise Specified_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA0","description":"ICD-JCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC1","description":"ICD-FGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE0","description":"ICD-KCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow up home visit/prental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1004","description":"Follow up home visit/prental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fern test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0114","description":"Fern test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA1","description":"ICD-FAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA110","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ewhfo rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3765","description":"Ewhfo rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc pt assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0157","description":"Hhc pt assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB0","description":"ICD-HARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58345","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","description":"HCPCS-J1553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86618","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin angio laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1885","description":"Cath_ translumin angio laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA0","description":"ICD-CFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release foot/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64726","description":"Release foot/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9824","description":"Endometrial sampling or hysteroscopy with biopsy and results not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA0","description":"ICD-MCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB0","description":"ICD-KHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx complex interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90785","description":"Psytx complex interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA1","description":"ICD-NCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0934T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","description":"CPT-0934T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC1","description":"ICD-GHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC1","description":"ICD-NDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB0","description":"ICD-KHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0679U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679U","description":"CPT-0679U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF0","description":"ICD-MKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0A","description":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth procedures on eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14051","description":"Anesth procedures on eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID1","description":"ICD-FDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0659U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0659U","description":"CPT-0659U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB1","description":"ICD-MDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroid activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84442","description":"Assay of thyroid activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE1","description":"ICD-CGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21282","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wellness assessment by nonph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5190","description":"Wellness assessment by nonph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC117","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD1","description":"ICD-OFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43620","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atomic absorption","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82190","description":"Atomic absorption","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA0","description":"ICD-ODAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53665","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole neo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3310","description":"Shoe lift elev heel/sole neo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB0","description":"ICD-GFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coll-e-Derm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4193","description":"Coll-e-Derm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0611","description":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE0","description":"ICD-OFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF1","description":"ICD-KGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC1","description":"ICD-MFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF1","description":"ICD-DERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD246","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE0","description":"ICD-CBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414U","description":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC0","description":"ICD-OJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF1","description":"ICD-MECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein access cutdown > 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36425","description":"Vein access cutdown > 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF1","description":"ICD-EGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD1","description":"ICD-AHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB0","description":"ICD-BEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA0","description":"ICD-HARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF0","description":"ICD-GDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Perfusion Echo Ischm/Viability Assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439T","description":"Myocardial Perfusion Echo Ischm/Viability Assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9367","description":"Hit tpn 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA31","description":"ICD-4EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryptosporidium ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87272","description":"Cryptosporidium ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13101","description":"Cmplx rpr trunk 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF1","description":"ICD-EBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA1","description":"ICD-BFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB1","description":"ICD-GEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES330","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE0","description":"ICD-IFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA1","description":"ICD-KBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27250","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Expandable controller_ repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2376","description":"Expandable controller_ repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27486","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3211","description":"Surgical boot each junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9760","description":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00800","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","description":"CPT-00800","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9342","description":"Hit enteral pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee disart expand wall sock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5653","description":"Knee disart expand wall sock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0498T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE1","description":"ICD-CAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD0","description":"ICD-JFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE0","description":"ICD-IDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA1","description":"ICD-MGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD1","description":"ICD-JHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB1","description":"ICD-BBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic us exam esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43237","description":"Endoscopic us exam esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA0","description":"ICD-OLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc new diag 1st/addl mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3093F","description":"Doc new diag 1st/addl mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF1","description":"ICD-GESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD0","description":"ICD-HBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC0","description":"ICD-GCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB1","description":"ICD-NLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dent anesthesia w/o surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9210","description":"Dent anesthesia w/o surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of circumcision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54163","description":"Repair of circumcision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/12-2.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2103","description":"Spherocylindr 4.00d/12-2.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Casting/strapping procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29799","description":"Casting/strapping procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy l/s facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64636","description":"Destroy l/s facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63664","description":"Revise spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE1","description":"ICD-GDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride nail 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11720","description":"Debride nail 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB1","description":"ICD-PIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB0","description":"ICD-MAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD0","description":"ICD-FEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0224","description":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE0","description":"ICD-LGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC0","description":"ICD-LHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spirom fev/fvc <70% w/copd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3025F","description":"Spirom fev/fvc <70% w/copd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE125","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7050","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA0","description":"ICD-NFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB1","description":"ICD-BAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28445","description":"Treat ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB1","description":"ICD-FFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled breath condensate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83987","description":"Exhaled breath condensate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE0","description":"ICD-CFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED0","description":"ICD-KHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA1","description":"ICD-OKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1240","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC1","description":"ICD-MGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1298","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose/water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7060","description":"5% dextrose/water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1802","description":"HCPCS-B1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB1","description":"ICD-MGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81337","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA1","description":"ICD-OEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF0","description":"ICD-HGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83525","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB1","description":"ICD-ABIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA0","description":"ICD-NLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1100T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1100T","description":"CPT-1100T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20610","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drill skull for implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61107","description":"Drill skull for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB1","description":"ICD-OEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD130","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt talk eval hlthwkr re mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2060F","description":"Pt talk eval hlthwkr re mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD1","description":"ICD-JHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery to vein shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36835","description":"Artery to vein shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA1","description":"ICD-GCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA226","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE134","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE1","description":"ICD-FINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC1","description":"ICD-GGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29700","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49592","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC43","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rna tstng hep c docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3218F","description":"Rna tstng hep c docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB0","description":"ICD-KCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF0","description":"ICD-KGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE0","description":"ICD-EHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","description":"HCPCS-A2027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA1","description":"ICD-NKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chloroquine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0390","description":"Chloroquine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD1","description":"ICD-GGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA0","description":"ICD-CDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cerclage suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59871","description":"Remove cerclage suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB0","description":"ICD-GHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macul exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2019F","description":"Dilated macul exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA1","description":"ICD-ACDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0533U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","description":"CPT-0533U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD1","description":"ICD-KHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA0","description":"ICD-ODJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA1","description":"ICD-MJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB1","description":"ICD-KBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45114","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC05","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF0","description":"ICD-OKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81309","description":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE1","description":"ICD-FCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repos nstim apnea sensing ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433T","description":"Repos nstim apnea sensing ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD1","description":"ICD-GBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19020","description":"Incision of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33611","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rehabilitative support for musculoskeletal care mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1370","description":"Rehabilitative support for musculoskeletal care mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC0","description":"ICD-PCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was provided hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9710","description":"Patient was provided hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug interven","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0022","description":"Alcohol and/or drug interven","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Octreotide inj_ non-depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2354","description":"Octreotide inj_ non-depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD1","description":"ICD-JEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND0","description":"ICD-FAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1704","description":"CDT-D1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB1","description":"ICD-GEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov part bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7230","description":"Impact tooth remov part bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC0","description":"ICD-PKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert balloon device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33973","description":"Insert balloon device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254T","description":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0532U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","description":"CPT-0532U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1150","description":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59820","description":"Care of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE1","description":"ICD-LDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA0","description":"ICD-BIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD1","description":"ICD-EEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD0","description":"ICD-JGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA1","description":"ICD-CIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC0","description":"ICD-CCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67105","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD1","description":"ICD-BHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4208","description":"3 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture tiss conditn maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5850","description":"Denture tiss conditn maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF1","description":"ICD-HCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB0","description":"ICD-ECBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB0","description":"ICD-IBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5943","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5943","description":"CDT-D5943","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11646","description":"Exc f/e/e/n/l mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31528","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA1","description":"ICD-KICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE241","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB240","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC21","description":"ICD-3KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF0","description":"ICD-GAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA1","description":"ICD-OBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osseous surgery per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4260","description":"Osseous surgery per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepc gn tstng docd b/4txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3266F","description":"Hepc gn tstng docd b/4txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93978","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cephalothin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1890","description":"Cephalothin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF0","description":"ICD-AECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC31","description":"ICD-2HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF0","description":"ICD-EAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20251","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC1","description":"ICD-KFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay nephelometry not spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83883","description":"Assay nephelometry not spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultraviolet therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97028","description":"Ultraviolet therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6062","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF1","description":"ICD-GCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2133","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6235","description":"Hydrocolld drg >16<=48 w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9750","description":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE0","description":"ICD-EGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8670","description":"Fun stat score ue not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymph choriomeningitis ab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86727","description":"Lymph choriomeningitis ab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF0","description":"ICD-GBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C diff amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87493","description":"C diff amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC1","description":"ICD-IFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27614","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58540","description":"Revision of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME0","description":"ICD-NCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rabies vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90675","description":"Rabies vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC1","description":"ICD-FEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB0","description":"ICD-GGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF0","description":"ICD-KEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anticonv thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4230F","description":"Anticonv thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND1","description":"ICD-BIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27356","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE0","description":"ICD-GCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop ea cast chg & realign","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6386","description":"Postop ea cast chg & realign","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of silica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84285","description":"Assay of silica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB1","description":"ICD-JFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD0","description":"ICD-EGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE0","description":"ICD-NCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF1","description":"ICD-DCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA1","description":"ICD-OHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92286","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33390","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA1","description":"ICD-JHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85555","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF0","description":"ICD-NCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC1","description":"ICD-LBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6453","description":"Self-adher band w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy administration with electroporation_ intramuscular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0732T","description":"Immunotherapy administration with electroporation_ intramuscular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC0","description":"ICD-IDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aorsubcl/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35626","description":"Art byp aorsubcl/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81465","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB0","description":"ICD-BHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC0","description":"ICD-OGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arm trough each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2209","description":"Arm trough each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0708T","description":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","description":"CPT-76015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine w/cath lmb/scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62319","description":"Inject spine w/cath lmb/scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap revision perm ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49325","description":"Lap revision perm ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25000","description":"Incision of tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA1","description":"ICD-GDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer fxd unilat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1510","description":"Space maintainer fxd unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0977T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","description":"CPT-0977T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD1","description":"ICD-GIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA0","description":"ICD-KBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection into vocal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31513","description":"Injection into vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15952","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF1","description":"ICD-JABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj >24 hr in ed gcs <15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9532","description":"Inj >24 hr in ed gcs <15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC11","description":"ICD-1DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB1","description":"ICD-OLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97170","description":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE0","description":"ICD-DAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95721","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46705","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD1","description":"ICD-OKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD1","description":"ICD-DCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53400","description":"Revise urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous blood process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86890","description":"Autologous blood process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90712","description":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA0","description":"ICD-GFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC1","description":"ICD-BEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363T","description":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA1","description":"ICD-GAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE0","description":"ICD-NLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68130","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA0","description":"ICD-CIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2110","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb no presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8697","description":"Antithromb no presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC31","description":"ICD-1KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB0","description":"ICD-HFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35556","description":"Art byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB1","description":"ICD-OLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","description":"HCPCS-J7528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB0","description":"ICD-GGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC31","description":"ICD-3LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00147","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","description":"CPT-00147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD0","description":"ICD-DCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE1","description":"ICD-CFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0518U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","description":"CPT-0518U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB1","description":"ICD-IIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA1","description":"ICD-EFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90705","description":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC1","description":"ICD-KFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1933","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","description":"HCPCS-L1933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC0","description":"ICD-EHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kras gene addl variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81276","description":"Kras gene addl variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47125","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral dexamethasone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8540","description":"Oral dexamethasone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD1","description":"ICD-OJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF1","description":"ICD-ODVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bortezomib injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9041","description":"Bortezomib injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo probably bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3343F","description":"Mammo probably bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacologic mgmt w/psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90863","description":"Pharmacologic mgmt w/psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED1","description":"ICD-MJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD1","description":"ICD-CBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1029","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1938","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","description":"HCPCS-J1938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9795","description":"Patient is not currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC0","description":"ICD-NAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair special seat dept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1297","description":"Wheelchair special seat dept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD0","description":"ICD-OBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF1","description":"ICD-FDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA0","description":"ICD-FALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD1","description":"ICD-AGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA0","description":"ICD-NCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA0","description":"ICD-LIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73100","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA0","description":"ICD-PERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis auto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81003","description":"Urinalysis auto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB0","description":"ICD-EEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD1","description":"ICD-ODDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD0","description":"ICD-FGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF0","description":"ICD-CBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD0","description":"ICD-JBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cstm manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0008","description":"Cstm manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD0","description":"ICD-FBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SUPRATHEL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2012","description":"SUPRATHEL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF0","description":"ICD-MFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB0","description":"ICD-PHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL50","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD1","description":"ICD-OKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE1","description":"ICD-PCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC0","description":"ICD-KDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0499","description":"Hepatitis B screening in non-pregnant_ high risk individual includes hepatitis B surface antigen (HBSAG) followed by a neutralizing confirmatory test for initially reactive re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0963T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","description":"CPT-0963T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9304","description":"Pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB1","description":"ICD-FDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0312","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA1","description":"ICD-KFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND1","description":"ICD-FFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE1","description":"ICD-GBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4A","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF0","description":"ICD-KFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of heart lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93505","description":"Biopsy of heart lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1556","description":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD1","description":"ICD-IEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC0","description":"ICD-JDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA1","description":"ICD-GEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10mg (bavencio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9491","description":"Injection_ avelumab_ 10mg (bavencio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD0","description":"ICD-FCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD0","description":"ICD-JHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric unresectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9102","description":"Onc dx gastric unresectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC1","description":"ICD-NDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE141","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75896","description":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX52","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt screened for depression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1220F","description":"Pt screened for depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44626","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD0","description":"ICD-GFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB1","description":"ICD-LERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD1","description":"ICD-GGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA1","description":"ICD-PLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA0","description":"ICD-KBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB1","description":"ICD-CGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF0","description":"ICD-HBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF0","description":"ICD-KEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED1","description":"ICD-OJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA0","description":"ICD-JIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD1","description":"ICD-NFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB1","description":"ICD-GDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB1","description":"ICD-ODOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA1","description":"ICD-JGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF1","description":"ICD-OEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL12","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb musc/fascia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11046","description":"Deb musc/fascia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD1","description":"ICD-GAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC1","description":"ICD-KCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF0","description":"ICD-GAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Daclizumab_ parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7513","description":"Daclizumab_ parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA0","description":"ICD-AHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB1","description":"ICD-OCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF0","description":"ICD-LESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70558","description":"MRI brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ full leg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6586","description":"Gradient pressure wrap with adjustable straps_ full leg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2214","description":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC0","description":"ICD-NFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA32","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD260","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy orchiopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54692","description":"Laparoscopy orchiopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD1","description":"ICD-OCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF0","description":"ICD-OAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eculizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1300","description":"Eculizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98984","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","description":"CPT-98984","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habilitation_ prevocational_ waiver; per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2047","description":"Habilitation_ prevocational_ waiver; per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA21","description":"ICD-2HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC1","description":"ICD-ODHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD1","description":"ICD-KGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0604","description":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF1","description":"ICD-BIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF0","description":"ICD-OLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD0","description":"ICD-CDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE1","description":"ICD-KFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA1","description":"ICD-CFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21431","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pcp prophylaxis rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4279F","description":"Pcp prophylaxis rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB0","description":"ICD-PLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Etoposide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9181","description":"Etoposide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF0","description":"ICD-LIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue soft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7286","description":"Biopsy of oral tissue soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1590","description":"Hemodialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dorsiflexion assist each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2210","description":"Dorsiflexion assist each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC0","description":"ICD-GITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA0","description":"ICD-FCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF0","description":"ICD-OBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace thrc unit hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052T","description":"Replace thrc unit hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Yersinia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86793","description":"Yersinia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plastic mold recipro hip & c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2627","description":"Plastic mold recipro hip & c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED1","description":"ICD-BDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0205","description":"Alglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric no recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9100","description":"Onc dx gastric no recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harness figure of 8 sing con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6675","description":"Harness figure of 8 sing con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proton treatment complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77525","description":"Proton treatment complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84550","description":"Assay of blood/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 4/5vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72050","description":"X-ray exam neck spine 4/5vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB0","description":"ICD-BIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD1","description":"ICD-OEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF1","description":"ICD-DDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA0","description":"ICD-OFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Expandable controller_ initl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2377","description":"Expandable controller_ initl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB1","description":"ICD-CDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crisis intervention per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9484","description":"Crisis intervention per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE1","description":"ICD-PJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1A","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF1","description":"ICD-FGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ublituximab-xiiy_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2329","description":"Injection_ ublituximab-xiiy_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA1","description":"ICD-MBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC1","description":"ICD-IEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE1","description":"ICD-OFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med serv eve/wkend/holiday","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99051","description":"Med serv eve/wkend/holiday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC1","description":"ICD-EHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD0","description":"ICD-AECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0503","description":"HCPCS-A0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58180","description":"Partial hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA1","description":"ICD-MKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus surgery for veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43401","description":"Esophagus surgery for veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB11","description":"ICD-3LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID0","description":"ICD-FEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE0","description":"ICD-KDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE1","description":"ICD-IILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB121","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB1","description":"ICD-OLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE1","description":"ICD-FHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33535","description":"Cabg arterial three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leucovorin calcium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0640","description":"Leucovorin calcium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33902","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6013","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seizure type& frequ docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1200F","description":"Seizure type& frequ docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB0","description":"ICD-MKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1902","description":"HCPCS-B1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0492","description":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4029","description":"Preventive Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA0","description":"ICD-MLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC0","description":"ICD-BHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA0","description":"ICD-ODNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed ditromethamine_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9323","description":"Injection_ pemetrexed ditromethamine_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME1","description":"ICD-OGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD1","description":"ICD-NBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lobar lung transplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2060","description":"Lobar lung transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC1","description":"ICD-GICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qty act mcc mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9670","description":"Qty act mcc mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA0","description":"ICD-BHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC1","description":"ICD-JGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND0","description":"ICD-OKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD1","description":"ICD-CFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65265","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19083","description":"Bx breast 1st lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA1","description":"ICD-CIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2005","description":"HCPCS-B2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hmes filter holder or cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7503","description":"Hmes filter holder or cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec knee-shin swing only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5857","description":"Elec knee-shin swing only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF1","description":"ICD-OIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB0","description":"ICD-KAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","description":"CPT-90484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF0","description":"ICD-OBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB0","description":"ICD-FEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA1","description":"ICD-KFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE1","description":"ICD-NJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA60","description":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE1","description":"ICD-MECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA1","description":"ICD-ACIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF1","description":"ICD-DAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD0","description":"ICD-HISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC1","description":"ICD-BCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA21","description":"ICD-1JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB1","description":"ICD-OIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76080","description":"X-ray exam of fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD0","description":"ICD-DIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays for bone age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77072","description":"X-rays for bone age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC0","description":"ICD-JGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA0","description":"ICD-JFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0691U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691U","description":"CPT-0691U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA0","description":"ICD-CFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF1","description":"ICD-NGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC1","description":"ICD-OHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC14","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD1","description":"ICD-NLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE0","description":"ICD-BEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC21","description":"ICD-1LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Warming card for nwt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0232","description":"Warming card for nwt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","description":"HCPCS-J1326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC0","description":"ICD-HIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4031","description":"Cast sup lng leg ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60200","description":"Remove thyroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7549","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Brolucizumab-Dbll_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0179","description":"Injection_ Brolucizumab-Dbll_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC11","description":"ICD-4GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC1","description":"ICD-CEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21240","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc cranial intra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61781","description":"Scan proc cranial intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33803","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD1","description":"ICD-JBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC0","description":"ICD-JIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte assessment fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89055","description":"Leukocyte assessment fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA1","description":"ICD-OILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI w/stress img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75559","description":"Cardiac MRI w/stress img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE1","description":"ICD-KETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pouch w bltinconv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4429","description":"Urine ost pouch w bltinconv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC0","description":"ICD-MCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30000","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef adult fluids and electro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4102","description":"Ef adult fluids and electro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","description":"HCPCS-M1424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC224","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34401","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD0","description":"ICD-ICTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF1","description":"ICD-JGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF1","description":"ICD-KIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB1","description":"ICD-KAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD0","description":"ICD-MDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","description":"CPT-01382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF1","description":"ICD-NHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB1","description":"ICD-OEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9907","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7351","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28003","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA1","description":"ICD-PCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB0","description":"ICD-OGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50390","description":"Drainage of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB0","description":"ICD-JDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology Cardiac Specialist Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4002","description":"Electrophysiology Cardiac Specialist Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD1","description":"ICD-CIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion supplies w/o pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4223","description":"Infusion supplies w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resuscitation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8999","description":"Resuscitation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA0","description":"ICD-EFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ewhfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3766","description":"Ewhfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD0","description":"ICD-KCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD0","description":"ICD-DDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE1","description":"ICD-MDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB1","description":"ICD-KINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD0","description":"ICD-KFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62324","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mdd severe w/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3091F","description":"Mdd severe w/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB0","description":"ICD-GDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB0","description":"ICD-IDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB1","description":"ICD-EEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF0","description":"ICD-MBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE1","description":"ICD-FBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE0","description":"ICD-KGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE0","description":"ICD-PJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC0","description":"ICD-OLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF1","description":"ICD-KIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteric identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87118","description":"Mycobacteric identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241U","description":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB1","description":"ICD-OCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD145","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE0","description":"ICD-CEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID0","description":"ICD-JCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA1","description":"ICD-IHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC20","description":"Ultra High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC0","description":"ICD-GDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4560","description":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27215","description":"Treat pelvic fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA0","description":"ICD-JGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC255","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1267","description":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA135","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25320","description":"Repair/revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF0","description":"ICD-KAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43360","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF1","description":"ICD-BGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF1","description":"ICD-NGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0757T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nonunion carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25431","description":"Repair nonunion carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic acrylic soc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5631","description":"Ak/knee disartic acrylic soc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE0","description":"ICD-NBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0305","description":"HCPCS-A0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable home suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0743","description":"Portable home suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Set up port xray equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0092","description":"Set up port xray equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52284","description":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0752T","description":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9981","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77605","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC26","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC0","description":"ICD-JHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB0","description":"ICD-ECEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88368","description":"Insitu hybridization manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Omental flap extra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49904","description":"Omental flap extra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Induction of vomiting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99175","description":"Induction of vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/2-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34802","description":"Endovas aaa repr w/2-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE0","description":"ICD-AIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB0","description":"ICD-EAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromatrix nerve cuff_ cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9355","description":"Neuromatrix nerve cuff_ cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE1","description":"ICD-GFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27780","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86756","description":"Respiratory virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0841","description":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA1","description":"ICD-JIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB1","description":"ICD-AHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo result com to pt 5 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5062F","description":"Mammo result com to pt 5 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9882","description":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD0","description":"ICD-JEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA0","description":"ICD-KAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA0","description":"ICD-IDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA0","description":"ICD-LGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME1","description":"ICD-MHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD0","description":"ICD-NGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61530","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA0","description":"ICD-OFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad glove heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8426","description":"Custom grad glove heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA0","description":"ICD-CBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear exam of tear flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78660","description":"Nuclear exam of tear flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB0","description":"ICD-NLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384U","description":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral busulfan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8510","description":"Oral busulfan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE1","description":"ICD-NHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0772T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF1","description":"ICD-GAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8694","description":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD1","description":"ICD-FIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0546U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","description":"CPT-0546U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA11","description":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reloc skin pocket pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416T","description":"Reloc skin pocket pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pegaptanib sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2503","description":"Pegaptanib sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC0","description":"ICD-JIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA1","description":"ICD-CHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA21","description":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgigraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4183","description":"Surgigraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB1","description":"ICD-FBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro acetabuloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29915","description":"Hip arthro acetabuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC0","description":"ICD-GCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8841","description":"No sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral antral fistula closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7260","description":"Oral antral fistula closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anticoag thx rx at dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4075F","description":"Anticoag thx rx at dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB0","description":"ICD-HEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF0","description":"ICD-KEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8X","description":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE1","description":"ICD-BDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA0","description":"ICD-IELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA50","description":"Medium Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC0","description":"ICD-EGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq revasc byp graft addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92938","description":"Prq revasc byp graft addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF0","description":"ICD-AHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB1","description":"ICD-JIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD0","description":"ICD-CFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD1","description":"ICD-GEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA1","description":"ICD-KGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE1","description":"ICD-GAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE146","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8671","description":"Fun stat score neck/ts >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA0","description":"ICD-OHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA1","description":"ICD-CCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA1","description":"ICD-DBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB22","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA1","description":"ICD-GCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotd art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36224","description":"Place cath carotd art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD0","description":"ICD-NKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6123","description":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73000","description":"X-ray exam of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF1","description":"ICD-KBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC0","description":"ICD-PCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77370","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (Perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9037","description":"Injection_ risperidone (Perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD226","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22595","description":"Neck spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC0","description":"ICD-OGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11626","description":"Exc s/n/h/f/g mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22325","description":"Treat spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB0","description":"ICD-NDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF0","description":"ICD-IGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD0","description":"ICD-BAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC0","description":"ICD-KCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF1","description":"ICD-KBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47612","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB0","description":"ICD-CBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB0","description":"ICD-BFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA0","description":"ICD-CAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","description":"CPT-00916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA0","description":"ICD-MITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21825","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0C","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE1","description":"ICD-PIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB06","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 or more neuropsych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8947","description":"1 or more neuropsych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak/hip alignable system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5920","description":"Endo ak/hip alignable system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases any combination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82803","description":"Blood gases any combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2 pc drainable ost pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4413","description":"2 pc drainable ost pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1090T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1090T","description":"CPT-1090T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasma 1 donor frz w/in 8 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9017","description":"Plasma 1 donor frz w/in 8 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","description":"CPT-00124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB1","description":"ICD-FFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC0","description":"ICD-NGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF0","description":"ICD-CCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA1","description":"ICD-KEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX03","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay carbamazepine total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80156","description":"Assay carbamazepine total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC1","description":"ICD-CHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment facehood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6503","description":"Compres burngarment facehood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj dobutamine hcl/250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1250","description":"Inj dobutamine hcl/250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB1","description":"ICD-OFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cid ext controller repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8628","description":"Cid ext controller repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd shck absrbr for hd man wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1017","description":"Hd shck absrbr for hd man wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0A","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Morphine 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0093","description":"Morphine 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB0","description":"ICD-EBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25900","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB1","description":"ICD-CAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF1","description":"ICD-BIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD1","description":"ICD-KFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99211","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9460","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX26","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic ring fx treat int fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0414","description":"Pelvic ring fx treat int fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40650","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB0","description":"ICD-EHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87337","description":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD1","description":"ICD-OHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB0","description":"ICD-OGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC1","description":"ICD-NDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE0","description":"ICD-LGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF0","description":"ICD-KIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28406","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB1","description":"ICD-LBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE0","description":"ICD-KFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74260","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8685","description":"Implt nrostm pls gen sng rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF0","description":"ICD-OCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64898","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92629","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","description":"CPT-92629","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE0","description":"ICD-CGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9814","description":"HCPCS-C9814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD0","description":"ICD-BHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aldesleukin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9015","description":"Aldesleukin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA0","description":"ICD-NIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0032","description":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Second level cer diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22858","description":"Second level cer diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE0","description":"ICD-NKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF0","description":"ICD-HDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9376","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC0","description":"ICD-IHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1141","description":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA0","description":"ICD-CAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC1","description":"ICD-IGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA0","description":"ICD-GCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0959T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","description":"CPT-0959T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","description":"HCPCS-J1171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE0","description":"ICD-KBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23530","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC21","description":"ICD-3HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11103","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML07","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial laminated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5590","description":"Prep ak ischial laminated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med reas no perf foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9502","description":"Med reas no perf foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC0","description":"ICD-EAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Pasireotide Long Acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9454","description":"Injection_ Pasireotide Long Acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion palate prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42281","description":"Insertion palate prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC1","description":"ICD-LHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9845","description":"Patient received anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84425","description":"Assay of vitamin b-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1834","description":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB0","description":"ICD-EBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA1","description":"ICD-OLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC0","description":"ICD-EDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community/work reintegration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97537","description":"Community/work reintegration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA0","description":"ICD-BILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF0","description":"ICD-CIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA1","description":"ICD-MECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA1","description":"ICD-OHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA0","description":"ICD-FHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD1","description":"ICD-BFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB1","description":"ICD-NGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD1","description":"ICD-MECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF0","description":"ICD-OKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78496","description":"Heart first pass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC03","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC1","description":"ICD-ADAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1329","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB1","description":"ICD-ODDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt above elbow disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6884","description":"Replc sockt above elbow disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF1","description":"ICD-FEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA0","description":"ICD-LBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93588","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronidase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3473","description":"Hyaluronidase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE0","description":"ICD-BAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE1","description":"ICD-NFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temp fml iu valve-pmp rplcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0597T","description":"Temp fml iu valve-pmp rplcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE101","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE0","description":"ICD-AATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD0","description":"ICD-FBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth fat layer removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80251","description":"Anesth fat layer removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB1","description":"ICD-GCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE0","description":"ICD-JIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34151","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD1","description":"ICD-AADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB0","description":"ICD-DAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43215","description":"Esophagoscopy flex remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC0","description":"ICD-ODWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nafcillin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0032","description":"Injection_ nafcillin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36831","description":"Open thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1270","description":"Wheelchair lightweight leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery cables","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4612","description":"Battery cables","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assistive technology assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97755","description":"Assistive technology assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93146","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","description":"CPT-93146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE1","description":"ICD-JFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting segmented","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7944","description":"Bone cutting segmented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB0","description":"ICD-CFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA1","description":"ICD-NKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD0","description":"ICD-EHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA0","description":"ICD-MLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC0","description":"ICD-NABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE0","description":"ICD-BDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB1","description":"ICD-EDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF0","description":"ICD-KFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC1","description":"ICD-NBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA31","description":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97039","description":"Physical therapy treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB1","description":"ICD-ICIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening performed and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9920","description":"Screening performed and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA1","description":"ICD-GCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF0","description":"ICD-OIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF0","description":"ICD-PLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD1","description":"ICD-JFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening barbiturates","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80345","description":"Drug screening barbiturates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF0","description":"ICD-GGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME0","description":"ICD-NKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9035","description":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD1","description":"ICD-CIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD0","description":"ICD-KCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA0","description":"ICD-NCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052U","description":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77061","description":"Breast tomosynthesis uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD151","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90693","description":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; unilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8904","description":"Magnetic resonance imaging without contrast_ breast; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF0","description":"ICD-BEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF0","description":"ICD-CHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC1","description":"ICD-MEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tooth reimplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7270","description":"Tooth reimplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40527","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE1","description":"ICD-BEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0719T","description":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA0","description":"ICD-KEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB1","description":"ICD-GHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","description":"HCPCS-M1413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA0","description":"ICD-OCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3271F","description":"Low risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF1","description":"ICD-EDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0661","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","description":"HCPCS-G0661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID1","description":"ICD-KCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA1","description":"ICD-BDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7327","description":"Monovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC1","description":"ICD-CDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD0","description":"ICD-OFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD1","description":"ICD-LDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB1","description":"ICD-PLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","description":"CPT-01714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96111","description":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF0","description":"ICD-GCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8I","description":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE1","description":"ICD-ICUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA0","description":"ICD-ODDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Slings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4565","description":"Slings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD111","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE0","description":"ICD-NKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC0","description":"ICD-HBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD1","description":"ICD-KBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31610","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4037","description":"Cast sup shrt leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF1","description":"ICD-GBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB1","description":"ICD-EIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA1","description":"ICD-BCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC1","description":"ICD-HBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77334","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4593","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7294","description":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC1","description":"ICD-CEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA0","description":"ICD-OCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD0","description":"ICD-IDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12053","description":"Intmd rpr face/mm 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE1","description":"ICD-JIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE1","description":"ICD-ADHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE1","description":"ICD-CFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1670","description":"Tetanus immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF1","description":"ICD-OIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE106","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laiv3 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90660","description":"Laiv3 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB1","description":"ICD-NELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB1","description":"ICD-OLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE0","description":"ICD-OLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB0","description":"ICD-NHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA1","description":"ICD-NCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC245","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD1","description":"ICD-MDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE0","description":"ICD-CFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest auto stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38206","description":"Harvest auto stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0430","description":"Fixed wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA1","description":"ICD-OJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED0","description":"ICD-JDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA1","description":"ICD-MFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA0","description":"ICD-FGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0013","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gene test hippel-lindau","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3842","description":"Gene test hippel-lindau","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE1","description":"ICD-GIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair skull cavity lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62120","description":"Repair skull cavity lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD0","description":"ICD-BATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0045","description":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Language screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5363","description":"Language screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA0","description":"ICD-JFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC1","description":"ICD-FELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE1","description":"ICD-JCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disartic myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6965","description":"Shldr disartic myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF0","description":"ICD-NJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC1","description":"ICD-CEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE1","description":"ICD-GIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transpetrosal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61598","description":"Transpetrosal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA0","description":"ICD-JCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB0","description":"ICD-BBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood other sources","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82271","description":"Occult blood other sources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc order cefazolin/cefurox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4041F","description":"Doc order cefazolin/cefurox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31002","description":"Irrigation sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE0","description":"ICD-DBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair brow defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67900","description":"Repair brow defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC0","description":"ICD-FBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval on foot documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8410","description":"Eval on foot documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC1","description":"ICD-BBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Viper venom prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85612","description":"Viper venom prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296T","description":"Ext ecg recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC0","description":"ICD-PAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2220","description":"Solid propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Particle agglut antbdy titr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86406","description":"Particle agglut antbdy titr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC1","description":"ICD-LEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement interface spsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1821","description":"Replacement interface spsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53661","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB0","description":"ICD-DGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx transantral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21385","description":"Opn tx orbit fx transantral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep cadaver renal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50323","description":"Prep cadaver renal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB0","description":"ICD-GHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00563","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","description":"CPT-00563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opps service_sched team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0175","description":"Opps service_sched team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD0","description":"ICD-NHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26540","description":"Repair hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE1","description":"ICD-JBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA11","description":"ICD-2IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulm funct tst plethysmograp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94726","description":"Pulm funct tst plethysmograp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surgery complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66982","description":"Cataract surgery complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61736","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2024","description":"Telecare equipment installation and removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD1","description":"ICD-OHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE0","description":"ICD-LIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD0","description":"ICD-HHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11621","description":"Exc s/n/h/f/g mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA0","description":"ICD-BIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD1","description":"ICD-FGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA0","description":"ICD-AETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD1","description":"ICD-CIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32151","description":"Remove lung foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interspinous implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1821","description":"Interspinous implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perphenazine injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3310","description":"Perphenazine injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise aqueous shunt eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66185","description":"Revise aqueous shunt eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF1","description":"ICD-GARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA1","description":"ICD-OEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst incl t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58552","description":"Laparo-vag hyst incl t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB0","description":"ICD-BAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no elg phar ther osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8634","description":"Pt no elg phar ther osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk/ak locking mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5671","description":"Bk/ak locking mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB0","description":"ICD-DBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE1","description":"ICD-BGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen imp urinary 2.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8603","description":"Collagen imp urinary 2.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF1","description":"ICD-DGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68550","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID1","description":"ICD-FHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF0","description":"ICD-BGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC0","description":"ICD-BICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47399","description":"Liver surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKC1","description":"ICD-NBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB0","description":"ICD-MEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth ear surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12051","description":"Anesth ear surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB1","description":"ICD-FHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA0","description":"ICD-JIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX23","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9150","description":"Medical home level iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF0","description":"ICD-CFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC0","description":"ICD-DGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC0","description":"ICD-ADIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectal marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46030","description":"Removal of rectal marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC1","description":"ICD-KHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF1","description":"ICD-ICLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF1","description":"ICD-IIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5B","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD0","description":"ICD-GEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Graft repair of spine defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63710","description":"Graft repair of spine defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9765","description":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0149U","description":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair pail or pan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0167","description":"Commode chair pail or pan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of femur 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73551","description":"X-ray exam of femur 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD0","description":"ICD-GIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86413","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31800","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB11","description":"ICD-3KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB1","description":"ICD-LGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29825","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC240","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC155","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1034","description":"Art pancreas system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE1","description":"ICD-GASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA16","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","description":"CPT-01522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97034","description":"Contrast bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF1","description":"ICD-IAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC0","description":"ICD-IIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74221","description":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0945T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","description":"CPT-0945T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0929T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","description":"CPT-0929T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA0","description":"ICD-GGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33962","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96369","description":"Sc ther infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC1","description":"ICD-OISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC1","description":"ICD-OBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA1","description":"ICD-MEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF0","description":"ICD-OCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF1","description":"ICD-EFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID0","description":"ICD-MIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD1","description":"ICD-LIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE0","description":"ICD-CIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE1","description":"ICD-BBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2010","description":"Apis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6604","description":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC236","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Basic vestibular evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92540","description":"Basic vestibular evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35616","description":"Art byp subclav-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF0","description":"ICD-BCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE1","description":"ICD-KDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI compatible system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0859","description":"MRI compatible system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25443","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC1","description":"ICD-BCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF1","description":"ICD-NJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49186","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","description":"CPT-49186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE0","description":"ICD-CBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF0","description":"ICD-ABCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB1","description":"ICD-JAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound char size etc docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2050F","description":"Wound char size etc docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF0","description":"ICD-CFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB141","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD1","description":"ICD-JFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE0","description":"ICD-DIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD0","description":"ICD-PKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC31","description":"ICD-4DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC0","description":"ICD-FEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ velmanase alfa-tycv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0217","description":"Injection_ velmanase alfa-tycv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25101","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9322","description":"Injection_ pemetrexed (bluepoint) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159U","description":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43289","description":"Laparoscope proc esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA1","description":"ICD-OCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61680","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29885","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD1","description":"ICD-CDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive review of data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88325","description":"Comprehensive review of data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE1","description":"ICD-OBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF1","description":"ICD-FFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC1","description":"ICD-MCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB0","description":"ICD-OFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA1","description":"ICD-ABMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC1","description":"ICD-BELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF0","description":"ICD-ADHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF0","description":"ICD-GEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC0","description":"ICD-KDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB0","description":"ICD-OBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA0","description":"ICD-GGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea scrnd no-mild dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3450F","description":"Dyspnea scrnd no-mild dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB1","description":"ICD-CBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE0","description":"ICD-OESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC1","description":"ICD-GHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB0","description":"ICD-OJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0301","description":"HCPCS-B0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE1","description":"ICD-BIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water pressure pad for mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0198","description":"Water pressure pad for mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vol reduction of blood/prod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86960","description":"Vol reduction of blood/prod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam dressing wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6215","description":"Foam dressing wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tamoxifen/ai prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4179F","description":"Tamoxifen/ai prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36516","description":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF1","description":"ICD-OHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE1","description":"ICD-FDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE0","description":"ICD-KFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63064","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE0","description":"ICD-NFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 6/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64647","description":"Chemodenerv trunk musc 6/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF0","description":"ICD-CFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44391","description":"Colonoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Dalbavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9443","description":"Injection_ Dalbavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95972","description":"Analyze neurostim complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB1","description":"ICD-OGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE0","description":"ICD-JALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB0","description":"ICD-PGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62329","description":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adenovirus ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87260","description":"Adenovirus ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB35","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE0","description":"ICD-BDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0882T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"E-Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4318","description":"E-Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0662U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0662U","description":"CPT-0662U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1806","description":"HCPCS-A1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complement/function activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86161","description":"Complement/function activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC0","description":"ICD-OLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED1","description":"ICD-CGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estradiol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82670","description":"Assay of estradiol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Activation device for intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1011","description":"Activation device for intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC0","description":"ICD-CBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral med adm direct observe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0033","description":"Oral med adm direct observe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Islet cell antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86341","description":"Islet cell antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hmes/trachvalve adhesivedisk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7506","description":"Hmes/trachvalve adhesivedisk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB1","description":"ICD-IDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD1","description":"ICD-OKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70557","description":"MRI brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1041","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo multilig ank sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1906","description":"Afo multilig ank sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML60","description":"Medium Rehab plus Extensive_ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatobil syst image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78227","description":"Hepatobil syst image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9038","description":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF0","description":"ICD-DERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE1","description":"ICD-GHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC0","description":"ICD-MDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF0","description":"ICD-FBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81376","description":"Hla ii typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES155","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB1","description":"ICD-CEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF0","description":"ICD-BDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81321","description":"Pten gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-htn or htn doc_ f/u indc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8950","description":"Pre-htn or htn doc_ f/u indc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5157","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","description":"HCPCS-Q5157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath occlusion cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61624","description":"Transcath occlusion cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43501","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD1","description":"ICD-FHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC0","description":"ICD-MHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC1","description":"ICD-MDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC116","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA31","description":"ICD-1KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0105U","description":"Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit chemo per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9329","description":"Hit chemo per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibody; Zika virus_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86794","description":"Antibody; Zika virus_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64451","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert heart pm atrial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33206","description":"Insert heart pm atrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9176","description":"Speech lang d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD0","description":"ICD-PBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC0","description":"ICD-BIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal vitamins 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0197","description":"Prenatal vitamins 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE1","description":"ICD-CFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC1","description":"ICD-KDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA0","description":"ICD-KCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj fem cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64448","description":"N block inj fem cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB0","description":"ICD-MLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD0","description":"ICD-AEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF1","description":"ICD-OCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA0","description":"ICD-OGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31579","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC1","description":"ICD-GBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA1","description":"ICD-MFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88160","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA0","description":"ICD-KGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6057","description":"Custom abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27062","description":"Remove femur lesion/bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1022","description":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA1","description":"ICD-DHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove exostosis maxilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21032","description":"Remove exostosis maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA0","description":"ICD-BGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX21","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Galactose transferase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82776","description":"Galactose transferase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA1","description":"ICD-KHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7547","description":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6552","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC1","description":"ICD-MJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26650","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27437","description":"Revise kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC0","description":"ICD-CCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA0","description":"ICD-PBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0671T","description":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift incorp lift-chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0627","description":"Seat lift incorp lift-chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB0","description":"ICD-ODQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intro gastrointestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44500","description":"Intro gastrointestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB0","description":"ICD-OGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8858","description":"Not ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF0","description":"ICD-OCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0737","description":"HCPCS-E0737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF0","description":"ICD-NHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC0","description":"ICD-NAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0005","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"repair cast partial framework_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5621","description":"repair cast partial framework_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq cervicothoracic inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22510","description":"Perq cervicothoracic inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE0","description":"ICD-BGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD0","description":"ICD-JCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit periton dialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9339","description":"Hit periton dialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mw therapy for breast tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301T","description":"Mw therapy for breast tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB31","description":"ICD-1CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plate pheres leukoredu irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9037","description":"Plate pheres leukoredu irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","description":"HCPCS-M1417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC0","description":"ICD-OCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA0","description":"ICD-NAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA1","description":"ICD-IDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB11","description":"ICD-1KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA35","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64492","description":"Inj paravert f jnt c/t 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD0","description":"ICD-LIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA0","description":"ICD-IAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5731","description":"Denture reln cmplt mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9157","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB1","description":"ICD-KAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD1","description":"ICD-AGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnio tri-core amniotic_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4295","description":"Amnio tri-core amniotic_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lab labial veneer porcelain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2962","description":"Lab labial veneer porcelain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx dprsd front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21343","description":"Open tx dprsd front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40804","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29834","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB0","description":"ICD-MDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD1","description":"ICD-OIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5646","description":"Below knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA1","description":"ICD-KFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB0","description":"ICD-GERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27616","description":"Resect leg/ankle tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE0","description":"ICD-NGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA1","description":"ICD-NEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF0","description":"ICD-IFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB212","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment x10sv retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67228","description":"Treatment x10sv retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0714T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC1","description":"ICD-KABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB0","description":"ICD-JDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ABO GNOTYP ABO 7 EXONS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180U","description":"ABO GNOTYP ABO 7 EXONS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC21","description":"ICD-1AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Desoxycorticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82633","description":"Desoxycorticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA1","description":"ICD-JAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21081","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA130","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shdr fair lead cable direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6590","description":"Shdr fair lead cable direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF1","description":"ICD-BEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF1","description":"ICD-FAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0504U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","description":"CPT-0504U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair humerus with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24435","description":"Repair humerus with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD0","description":"ICD-BEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0913","description":"Improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fem hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49553","description":"Rpr fem hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF1","description":"ICD-AECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB1","description":"ICD-OBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD1","description":"ICD-GCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19081","description":"Bx breast 1st lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE1","description":"ICD-GBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/orogastric w/tube plmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43752","description":"Nasal/orogastric w/tube plmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF0","description":"ICD-GAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1102","description":"CDT-D1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-99445","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","description":"CPT-99445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA0","description":"ICD-BDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB1","description":"ICD-GALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE0","description":"ICD-FAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC1","description":"ICD-CFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD0","description":"ICD-HEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj vertbrl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35691","description":"Art trnsposj vertbrl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC1","description":"ICD-FIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42215","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND0","description":"ICD-JGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD0","description":"ICD-JBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc opioid tx 1x during ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9578","description":"Doc opioid tx 1x during ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD0","description":"ICD-CHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0170U","description":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD0","description":"ICD-OCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE1","description":"ICD-AITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen micrarray copy nmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81228","description":"Cytogen micrarray copy nmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61651","description":"Evasc prlng admn rx agnt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF1","description":"ICD-GCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE1","description":"ICD-FCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9763","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC1","description":"ICD-FEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC0","description":"ICD-CFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64774","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gum graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41870","description":"Gum graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC1","description":"ICD-JBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC1","description":"ICD-MFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF0","description":"ICD-BEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE1","description":"ICD-EAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD1","description":"ICD-CEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC0","description":"ICD-MCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC0","description":"ICD-CBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE1","description":"ICD-CHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00625","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","description":"CPT-00625","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kyphectomy 1-2 segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22818","description":"Kyphectomy 1-2 segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC1","description":"ICD-CAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD1","description":"ICD-PLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB11","description":"ICD-2AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stool cultr aerobic bact ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87046","description":"Stool cultr aerobic bact ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE1","description":"ICD-CAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29899","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp 5/>yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99149","description":"Mod sed diff phys/qhp 5/>yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD1","description":"ICD-MKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-131 iodide cap_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9528","description":"Iodine i-131 iodide cap_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD1","description":"ICD-CIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81284","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB0","description":"ICD-NLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE0","description":"ICD-CBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1023","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splice spleen/kidney veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37181","description":"Splice spleen/kidney veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB1","description":"ICD-BCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB0","description":"ICD-CBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA1","description":"ICD-FBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX41","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA55","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47511","description":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thromblytic art/ven therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37213","description":"Thromblytic art/ven therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA0","description":"ICD-LIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine vma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84585","description":"Assay of urine vma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC1","description":"ICD-JCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","description":"CPT-92638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD1","description":"ICD-KHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26496","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport taxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0100","description":"Nonemergency transport taxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC0","description":"ICD-MFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA1","description":"ICD-JGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA1","description":"ICD-GHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Daunorubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9150","description":"Daunorubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remis 12m not phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9510","description":"Remis 12m not phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro w/addl implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52442","description":"Cystourethro w/addl implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed adjust armrest pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0020","description":"Fixed adjust armrest pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD1","description":"ICD-CDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC0","description":"ICD-PEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35207","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE0","description":"ICD-KCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia interven rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4526F","description":"Neuropsychia interven rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpower mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0371","description":"Nonpower mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amiodarone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80151","description":"Amiodarone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1075T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1075T","description":"CPT-1075T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD0","description":"ICD-IGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air injection into abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49400","description":"Air injection into abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF1","description":"ICD-GALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294U","description":"Longevity And Mortality Risk_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 18 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cat scan follow-up study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76380","description":"Cat scan follow-up study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB0","description":"ICD-CGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF0","description":"ICD-PLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5940","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5940","description":"CDT-D5940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE1","description":"ICD-GFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436U","description":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE1","description":"ICD-NGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0B","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE0","description":"ICD-AGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC0","description":"ICD-BIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artiss fibrin sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9250","description":"Artiss fibrin sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD1","description":"ICD-PIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","description":"HCPCS-Q4399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC1","description":"ICD-DARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX20","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88037","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND1","description":"ICD-OHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE0","description":"ICD-AFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE0","description":"ICD-GFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pcp prophylax rxd 3mon low %","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4280F","description":"Pcp prophylax rxd 3mon low %","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26373","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID1","description":"ICD-MHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy unspecified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96549","description":"Chemotherapy unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test thor paraspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95869","description":"Muscle test thor paraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME1","description":"ICD-NLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF0","description":"ICD-GFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bladder abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51080","description":"Drainage of bladder abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polarization_ any lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2762","description":"Polarization_ any lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening proctoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0601","description":"Screening proctoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi abv up param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8417","description":"Calc bmi abv up param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165U","description":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE156","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert 1 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33216","description":"Insert 1 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC0","description":"ICD-DHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF0","description":"ICD-EAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD0","description":"ICD-LIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiom thresh & recog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211T","description":"Speech audiom thresh & recog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33647","description":"Repair heart septum defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC1","description":"ICD-OCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC1","description":"ICD-JACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7903","description":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA1","description":"ICD-NFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF0","description":"ICD-OCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct ulna/radioulnar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25337","description":"Reconstruct ulna/radioulnar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenylketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84035","description":"Assay of phenylketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA0","description":"ICD-JCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","description":"CPT-00932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8G","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF1","description":"ICD-MEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26785","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB1","description":"ICD-PBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA244","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA1","description":"ICD-FANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB1","description":"ICD-OIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC1","description":"ICD-NLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF1","description":"ICD-OGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0089","description":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5249","description":"Hearing aid_ binaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB234","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Charger and base station for intraurethral activation device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1012","description":"Charger and base station for intraurethral activation device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1304","description":"CDT-D1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB0","description":"ICD-GIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8G","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brca1 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81215","description":"Brca1 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9776","description":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE1","description":"ICD-DBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA1","description":"ICD-IAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363U","description":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA0","description":"ICD-OJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laiv4 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90672","description":"Laiv4 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA1","description":"ICD-GHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD0","description":"ICD-MAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 1 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34845","description":"Visc & infraren abd 1 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA1","description":"ICD-CCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8B","description":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB0","description":"ICD-NAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA1","description":"ICD-BBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF0","description":"ICD-MDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB0","description":"ICD-MITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduct compnd facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7780","description":"Reduct compnd facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC1","description":"ICD-OABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant femur ridge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27140","description":"Transplant femur ridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4380","description":"Urinary rubber pouch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj phrenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64410","description":"N block inj phrenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC0","description":"ICD-IDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE1","description":"ICD-CERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of testis(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54680","description":"Relocation of testis(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE1","description":"ICD-JHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic endoscope add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66990","description":"Ophthalmic endoscope add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t1-3_n1-2_no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9084","description":"Onc dx colon t1-3_n1-2_no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD1","description":"ICD-NEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB1","description":"ICD-PHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF1","description":"ICD-AFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21700","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0685","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0685","description":"HCPCS-G0685","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF1","description":"ICD-CIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF0","description":"ICD-MJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35512","description":"Art byp grft subclav-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antihemophilic viii/vwf comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7186","description":"Antihemophilic viii/vwf comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD0","description":"ICD-AHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21462","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deoxycortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82634","description":"Deoxycortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC1","description":"ICD-NHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0334U","description":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0480T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD1","description":"ICD-GHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB0","description":"ICD-FAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB1","description":"ICD-EDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD0","description":"ICD-OFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Narcosynthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90865","description":"Narcosynthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB104","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF1","description":"ICD-EHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41520","description":"Reconstruction tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF1","description":"ICD-OCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/sm tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34800","description":"Endovas aaa repr w/sm tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42305","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE1","description":"ICD-BCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC1","description":"ICD-FBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC1","description":"ICD-BHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of wrist capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25085","description":"Incision of wrist capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0A","description":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB0","description":"ICD-OJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48150","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE0","description":"ICD-NJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD0","description":"ICD-CDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE1","description":"ICD-OKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0201","description":"HCPCS-A0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthoptic training; under supervision of a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92066","description":"Orthoptic training; under supervision of a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD150","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","description":"CPT-37260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy implant stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52282","description":"Cystoscopy implant stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0602","description":"HCPCS-A0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME1","description":"ICD-NDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC0","description":"ICD-DDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control pelvic sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2580","description":"Pelvic control pelvic sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External recharg sys extern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8695","description":"External recharg sys extern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB0","description":"ICD-FIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF0","description":"ICD-LERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF0","description":"ICD-EFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB0","description":"ICD-PIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85415","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","description":"HCPCS-M1423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch ex wear convex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4390","description":"Drainable pch ex wear convex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD1","description":"ICD-HCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB0","description":"ICD-JHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB1","description":"ICD-JHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD0","description":"ICD-MACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50386","description":"Remove stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2005","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE1","description":"ICD-NLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB0","description":"ICD-GAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD1","description":"ICD-GGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD1","description":"ICD-NAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE0","description":"ICD-GEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9059","description":"Injection_ meloxicam_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25136","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA1","description":"ICD-BIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49595","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC0","description":"ICD-ADTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15200","description":"Skin full graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81546","description":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB1","description":"ICD-AGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fb reaction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7540","description":"Removal of fb reaction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63746","description":"Removal of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC1","description":"ICD-OGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect nasopharynx skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61586","description":"Resect nasopharynx skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB1","description":"ICD-GIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA0","description":"ICD-BGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE1","description":"ICD-MHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC1","description":"ICD-OHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82679","description":"Assay of estrone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pump for water circulating p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0236","description":"Pump for water circulating p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA0","description":"ICD-GBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC0","description":"ICD-CDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC0","description":"ICD-FITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA1","description":"ICD-NKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of ankle/heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28120","description":"Part removal of ankle/heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD1","description":"ICD-CAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA1","description":"ICD-MLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC11","description":"ICD-4AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray&fluoro 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71034","description":"Chest x-ray&fluoro 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE0","description":"ICD-ACIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73200","description":"Ct upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9840","description":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec med comp dev_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1505","description":"Elec med comp dev_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35082","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle or intracatheter_ upper or lower extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36140","description":"Introduction of needle or intracatheter_ upper or lower extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ suprapubic/cystoscopic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2627","description":"Cath_ suprapubic/cystoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC0","description":"ICD-GHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Health Safety)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7336","description":"Community Transition Svcs (Health Safety)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE1","description":"ICD-BITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC0","description":"ICD-KFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2213","description":"Lens sphcyl bifo 7.25-12/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91307","description":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch to home by day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8818","description":"Pt disch to home by day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB1","description":"ICD-MEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA1","description":"ICD-AIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx dental pain minor proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9110","description":"Tx dental pain minor proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA0","description":"ICD-JEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF0","description":"ICD-CIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE0","description":"ICD-CAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB1","description":"ICD-GACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87810","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD0","description":"ICD-HFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA1","description":"ICD-MDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86648","description":"Diphtheria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA0","description":"ICD-BCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA117","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69666","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70134","description":"X-ray exam of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75889","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB1","description":"ICD-CDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screen cerv/vag thin layer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0123","description":"Screen cerv/vag thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis blood pressure cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4663","description":"Dialysis blood pressure cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0205","description":"HCPCS-A0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF0","description":"ICD-CARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home health aide or certifie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9122","description":"Home health aide or certifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33517","description":"Cabg artery-vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprt fees/laryngeal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92617","description":"Interprt fees/laryngeal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB0","description":"ICD-GFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372T","description":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD1","description":"ICD-KIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90473","description":"Immune admin oral/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE1","description":"ICD-EDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabergoline_ oral 0.25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8515","description":"Cabergoline_ oral 0.25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF0","description":"ICD-AEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA260","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81179","description":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81221","description":"Cftr gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA1","description":"ICD-HIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD0","description":"ICD-KDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0404","description":"HCPCS-C0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 1 visit p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90956","description":"Esrd srv 1 visit p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD0","description":"ICD-CDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9289","description":"Doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75860","description":"Vein x-ray neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE1","description":"ICD-NFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transvaginal us non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76830","description":"Transvaginal us non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1002","description":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC0","description":"ICD-KFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0760T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0281","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","description":"HCPCS-J0281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20974","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE0","description":"ICD-NLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA1","description":"ICD-EHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA0","description":"ICD-HERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5947","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5947","description":"CDT-D5947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA0","description":"ICD-OBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA0","description":"ICD-DGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin bath unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0235","description":"Paraffin bath unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB1","description":"ICD-OBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND0","description":"ICD-OJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat trigeminal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61790","description":"Treat trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95851","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD0","description":"ICD-CIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antinuclear antibodies (ana)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86039","description":"Antinuclear antibodies (ana)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/review interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93272","description":"Ecg/review interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB0","description":"ICD-GDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intent pot remv time placemt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9539","description":"Intent pot remv time placemt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9999","description":"Chemotherapy drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD1","description":"ICD-MGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB1","description":"ICD-GIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB0","description":"ICD-JAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC0","description":"ICD-NGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49615","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF0","description":"ICD-LISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC0","description":"ICD-NGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE0","description":"ICD-HCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF0","description":"ICD-CCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB0","description":"ICD-OJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67120","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX11","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE0","description":"ICD-CFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB0","description":"ICD-CDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF1","description":"ICD-NECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gas system stationary compre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0425","description":"Gas system stationary compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus antibody dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87267","description":"Enterovirus antibody dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00162","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","description":"CPT-00162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC0","description":"ICD-CDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD0","description":"ICD-LESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF0","description":"ICD-FGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9072","description":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC1","description":"ICD-KDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther behav svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2019","description":"Ther behav svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD1","description":"ICD-IGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12037","description":"Intmd rpr s/tr/ext >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioBand_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4168","description":"AmnioBand_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell cnt 200-499 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3495F","description":"Cd4+cell cnt 200-499 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE0","description":"ICD-JHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC1","description":"ICD-PCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD0","description":"ICD-NBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29830","description":"Elbow arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6750","description":"Crown porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63275","description":"Bx/exc xdrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC0","description":"ICD-KHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","description":"CPT-00522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC121","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen based wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6010","description":"Collagen based wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90834","description":"Psytx pt&/family 45 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE1","description":"ICD-LHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rimantadine hcl_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9036","description":"Rimantadine hcl_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB1","description":"ICD-MAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE160","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","description":"HCPCS-M1436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE1","description":"ICD-GDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect diaphragm simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39560","description":"Resect diaphragm simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing assessment/evaluatn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1001","description":"Nursing assessment/evaluatn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA0","description":"ICD-NEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD1","description":"ICD-BDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53260","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureteral reflux study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78740","description":"Ureteral reflux study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF1","description":"ICD-BAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74183","description":"MRI abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE0","description":"ICD-KINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC0","description":"ICD-NJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC1","description":"ICD-OAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","description":"HCPCS-J2313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB1","description":"ICD-MBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0710T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC1","description":"ICD-JAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA1","description":"ICD-JAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL26","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA0","description":"ICD-PHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF0","description":"ICD-FFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image w/o drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78707","description":"K flow/funct image w/o drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC1","description":"ICD-PDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91851","description":"Anesth stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroestradiol f18_ diagnostic_ 1 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9060","description":"Fluoroestradiol f18_ diagnostic_ 1 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX52","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB0","description":"ICD-HFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of percutaneous biliary drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47525","description":"Change of percutaneous biliary drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC0","description":"ICD-BHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45541","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Volun service at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9476","description":"Volun service at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA1","description":"ICD-DGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","description":"HCPCS-Q4403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL35","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC0","description":"ICD-ACIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA0","description":"ICD-AFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA0","description":"ICD-KGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF0","description":"ICD-GASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA0","description":"ICD-FELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD0","description":"ICD-CCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE0","description":"ICD-ODBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB1","description":"ICD-NEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE1","description":"ICD-HEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA0","description":"ICD-IHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85421","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA0","description":"ICD-GGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ ciprofloxacin otic suspension_ 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7342","description":"Instillation_ ciprofloxacin otic suspension_ 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hm postpar hyper per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9212","description":"Hm postpar hyper per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise lumbar artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22862","description":"Revise lumbar artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD0","description":"ICD-BAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB1","description":"ICD-MDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mrs discogenic pain i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0612T","description":"Mrs discogenic pain i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB0","description":"ICD-JHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF1","description":"ICD-FBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC1","description":"ICD-GFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7531","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7531","description":"HCPCS-J7531","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA0","description":"ICD-KHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA1","description":"ICD-GIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cvr hip disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5707","description":"Custom shape cvr hip disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE151","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD1","description":"ICD-KDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb blker <3mos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4481F","description":"Pt rcvng ace/arb blker <3mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB1","description":"ICD-NHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA0","description":"ICD-FFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flu vacc iiv4 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90630","description":"Flu vacc iiv4 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8C","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE1","description":"ICD-GDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of orbit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21256","description":"Reconstruction of orbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC0","description":"ICD-GBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triptorelin extended release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9016","description":"Injection_ triptorelin extended release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB1","description":"ICD-BBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB1","description":"ICD-MKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporin parenteral 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7516","description":"Cyclosporin parenteral 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB1","description":"ICD-FITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA1","description":"ICD-NBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA1","description":"ICD-NDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","description":"HCPCS-M1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC1","description":"ICD-FGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstr w/lat flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19361","description":"Breast reconstr w/lat flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduct simple facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7680","description":"Reduct simple facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF0","description":"ICD-MHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97552","description":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF0","description":"ICD-JIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA0","description":"ICD-KFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD0","description":"ICD-OADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd bed tilted 1st day vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4167F","description":"Hd bed tilted 1st day vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF1","description":"ICD-KDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26517","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA0","description":"ICD-NCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray eye for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70030","description":"X-ray eye for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drugs unclassified injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3490","description":"Drugs unclassified injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64597","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8480","description":"Pros sock single ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF1","description":"ICD-OBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF1","description":"ICD-BCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE1","description":"ICD-BELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF1","description":"ICD-NEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC1","description":"ICD-KGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB146","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19082","description":"Bx breast add lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8633","description":"Pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic sigmoidoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45330","description":"Diagnostic sigmoidoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD114","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9356","description":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of free testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84402","description":"Assay of free testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC0","description":"ICD-OGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33774","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rprt bone scint xref w xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3570F","description":"Rprt bone scint xref w xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB1","description":"ICD-ACMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA1","description":"ICD-GBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE1","description":"ICD-KBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD0","description":"ICD-FDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures repair resin base","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5610","description":"Dentures repair resin base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6400","description":"Below elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD0","description":"ICD-CCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9311","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9311","description":"HCPCS-C9311","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy hand joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26100","description":"Biopsy hand joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB1","description":"ICD-LCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA0","description":"ICD-DASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38525","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35647","description":"Art byp aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF0","description":"ICD-KGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA0","description":"ICD-LHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humeral externally controlled intramedullary device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0595T","description":"Removal of humeral externally controlled intramedullary device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD1","description":"ICD-GIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE0","description":"ICD-ABAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC0","description":"ICD-JGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9075","description":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37660","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"P32 na phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9563","description":"P32 na phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak open end sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5321","description":"Ak open end sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA1","description":"ICD-GILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD1","description":"ICD-JITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE0","description":"ICD-OGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA1","description":"ICD-IDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ subcutaneous cardiac rhythm monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33286","description":"Removal_ subcutaneous cardiac rhythm monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD1","description":"ICD-OIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect mediastinal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39220","description":"Resect mediastinal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA0","description":"ICD-HBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC0","description":"ICD-CHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37275","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","description":"CPT-37275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB105","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF1","description":"ICD-JBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","description":"CPT-01840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA1","description":"ICD-CHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat tilt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1002","description":"Pwr seat tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC0","description":"ICD-GBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE0","description":"ICD-OBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB0","description":"ICD-AFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oocyte identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89254","description":"Oocyte identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA1","description":"ICD-AILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33900","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruct premalg les 2-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17003","description":"Destruct premalg les 2-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gastrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82941","description":"Assay of gastrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-63032","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","description":"CPT-63032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD0","description":"ICD-LHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0803","description":"HCPCS-B0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB0","description":"ICD-KCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56634","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA0","description":"ICD-GBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC0","description":"ICD-IHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB0","description":"ICD-MFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1057T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1057T","description":"CPT-1057T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Same day nb discharge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99463","description":"Same day nb discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF1","description":"ICD-JFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233T","description":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD0","description":"ICD-OGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA0","description":"ICD-GGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stocking sup grips 4 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0982","description":"Stocking sup grips 4 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9463","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD0","description":"ICD-OEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9343","description":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB1","description":"ICD-GBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Floxuridine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9200","description":"Floxuridine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF1","description":"ICD-BFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB42","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID1","description":"ICD-IFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4023","description":"Cast sup sht arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9022","description":"Injection_ atezolizumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chem/antisept solution_ 8oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4674","description":"Chem/antisept solution_ 8oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0C","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA0","description":"ICD-BAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF0","description":"ICD-MLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS BE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87350","description":"IAAD IA HEPATITIS BE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD1","description":"ICD-CGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC1","description":"ICD-PDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD0","description":"ICD-PKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace molded thigh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4040","description":"Replace molded thigh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA1","description":"ICD-KFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE1","description":"ICD-FELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD0","description":"ICD-FAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC0","description":"ICD-KIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF0","description":"ICD-NEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61850","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ibandronate sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1740","description":"Ibandronate sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB1","description":"ICD-NFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB20","description":"Very High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incid ct liver/kid/adre fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9547","description":"Incid ct liver/kid/adre fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reposition gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43761","description":"Reposition gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC1","description":"ICD-LGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig les complicat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7415","description":"Excision malig les complicat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA0","description":"ICD-ODPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF1","description":"ICD-NFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88235","description":"Tissue culture placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB116","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE1","description":"ICD-NAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA0","description":"ICD-GELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with nonreactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1231","description":"Patient receives hcv antibody test with nonreactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF0","description":"ICD-FCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery anal lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46917","description":"Laser surgery anal lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant microphone repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8616","description":"Coch implant microphone repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC1","description":"ICD-JHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC1","description":"ICD-OIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB0","description":"ICD-KEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB0","description":"ICD-BCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292U","description":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB0","description":"ICD-FANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE1","description":"ICD-OJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC1","description":"ICD-KANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0035U","description":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC1","description":"ICD-OICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD0","description":"ICD-OKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA1","description":"ICD-KAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA1","description":"ICD-AIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA41","description":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD1","description":"ICD-HGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID0","description":"ICD-NBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF0","description":"ICD-NFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77436","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","description":"CPT-77436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD0","description":"ICD-CHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC130","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA43","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","description":"HCPCS-A4544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aor ane >=6.0 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9599","description":"Aor ane >=6.0 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC1","description":"ICD-ECBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB0","description":"ICD-NBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC0","description":"ICD-BBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB1","description":"ICD-MCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace trilateral socket br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4010","description":"Replace trilateral socket br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of copper","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82525","description":"Assay of copper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF1","description":"ICD-HEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF0","description":"ICD-KIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE0","description":"ICD-GESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL46","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA0","description":"ICD-CBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker rigid adjust/fixed ht","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0130","description":"Walker rigid adjust/fixed ht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD1","description":"ICD-JGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59426","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF0","description":"ICD-OBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test urine for lactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83633","description":"Test urine for lactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC0","description":"ICD-EIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01760","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","description":"CPT-01760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA1","description":"ICD-JCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA0","description":"ICD-LCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE1","description":"ICD-KCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD1","description":"ICD-CFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA1","description":"ICD-ODYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant ureter in bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50800","description":"Implant ureter in bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove fix space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1555","description":"Remove fix space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE0","description":"ICD-AETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27637","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD1","description":"ICD-HFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6059","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB1","description":"ICD-GDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB0","description":"ICD-BGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE1","description":"ICD-NLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61541","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB1","description":"ICD-EFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC105","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE1","description":"ICD-OJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81470","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2D","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluor antb addl stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88350","description":"Immunofluor antb addl stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sipuleucel-t auto cd54+","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2043","description":"Sipuleucel-t auto cd54+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD1","description":"ICD-BBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC0","description":"ICD-LFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1301","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE0","description":"ICD-PJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9807","description":"HCPCS-C9807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9777","description":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4A","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD0","description":"ICD-OHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF0","description":"ICD-GGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58275","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC0","description":"ICD-NCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1404","description":"HCPCS-A1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA1","description":"ICD-HFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB0","description":"ICD-ABDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3984","description":"Upper ext fx orthosis wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF1","description":"ICD-MJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65110","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE0","description":"ICD-JAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy bra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8000","description":"Mastectomy bra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF0","description":"ICD-OHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54420","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69706","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD1","description":"ICD-FBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC0","description":"ICD-JENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD1","description":"ICD-NFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD0","description":"ICD-FABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD0","description":"ICD-CAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/curett of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57454","description":"Bx/curett of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED0","description":"ICD-GGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD0","description":"ICD-KDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA1","description":"ICD-IEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB0","description":"ICD-FICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD0","description":"ICD-LIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA1","description":"ICD-NIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB0","description":"ICD-GEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE0","description":"ICD-DEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB0","description":"ICD-OCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA0","description":"ICD-CBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB1","description":"ICD-PARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","description":"HCPCS-M1384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous methb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88741","description":"Transcutaneous methb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11100","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC1","description":"ICD-GGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB1","description":"ICD-GFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone srgry cmptr CT/MRI imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055T","description":"Bone srgry cmptr CT/MRI imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA1","description":"ICD-EDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA35","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA1","description":"ICD-FCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB151","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF1","description":"ICD-ACLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PROTON THERAPY","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77524","description":"PROTON THERAPY","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD0","description":"ICD-MJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123U","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA1","description":"ICD-NGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF1","description":"ICD-MHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA1","description":"ICD-CGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA1","description":"ICD-MDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sock fracture or equal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3995","description":"Sock fracture or equal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7628","description":"Bitolterol mesylate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB0","description":"ICD-PLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33478","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC1","description":"ICD-NELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular prosthesis interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5923","description":"Ocular prosthesis interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release encircling material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67115","description":"Release encircling material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME1","description":"ICD-MFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC0","description":"ICD-GBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF0","description":"ICD-NHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE1","description":"ICD-JBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA0","description":"ICD-CCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted e&m service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99499","description":"Unlisted e&m service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86738","description":"Mycoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE0","description":"ICD-GBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC1","description":"ICD-CIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1276","description":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD1","description":"ICD-LFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE1","description":"ICD-CGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood product/irradiation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86945","description":"Blood product/irradiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9175","description":"HCPCS-C9175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC1","description":"ICD-FFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE0","description":"ICD-PDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0606U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","description":"CPT-0606U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA1","description":"ICD-NLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC0","description":"ICD-MGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC1","description":"ICD-MLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD1","description":"ICD-CDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Na ferric gluconate complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2916","description":"Na ferric gluconate complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC0","description":"ICD-PCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA0","description":"ICD-OAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen 2 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33263","description":"Rmvl & rplcmt dfb gen 2 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA0","description":"ICD-CFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko immob canvas long pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1830","description":"Ko immob canvas long pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC120","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate >200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072T","description":"Us leiomyomata ablate >200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF1","description":"ICD-JIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC0","description":"ICD-OLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX07","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA1","description":"ICD-BAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD0","description":"ICD-JHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68328","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF0","description":"ICD-JGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4185","description":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529T","description":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family stabilization 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9482","description":"Family stabilization 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular inj of (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074A","description":"Imm admin by intramuscular inj of (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97165","description":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB1","description":"ICD-KIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF1","description":"ICD-AELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD154","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcondylar approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61597","description":"Transcondylar approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD0","description":"ICD-BFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE1","description":"ICD-HCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay ph body fluid nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83986","description":"Assay ph body fluid nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA1","description":"ICD-EEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8910","description":"Mra w/o cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19370","description":"Surgery of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68540","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC0","description":"ICD-KHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB1","description":"ICD-JFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF1","description":"ICD-OLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB215","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC1","description":"ICD-KAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE1","description":"ICD-JCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC0","description":"ICD-FGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dysphagia screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5364","description":"Dysphagia screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9555","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA0","description":"ICD-BGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lumbar puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63551","description":"Anesth lumbar puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE1","description":"ICD-JHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA1","description":"ICD-FHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA1","description":"ICD-JBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain bag/bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4911","description":"Drain bag/bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE0","description":"ICD-ACEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA0","description":"ICD-BAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5252","description":"Hearing aid_ prog_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB0","description":"ICD-MIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coroners autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88045","description":"Coroners autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family homecare train/sessio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5111","description":"Family homecare train/sessio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87591","description":"N.gonorrhoeae dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD0","description":"ICD-KAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF0","description":"ICD-OKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mh health assess by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0031","description":"Mh health assess by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m sulfur colloid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9541","description":"Tc99m sulfur colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF1","description":"ICD-BIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect shoulder tumor < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23077","description":"Resect shoulder tumor < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD1","description":"ICD-NBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE1","description":"ICD-OCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF1","description":"ICD-BFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC0","description":"ICD-BDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA0","description":"ICD-NKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap ins device for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49327","description":"Lap ins device for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA0","description":"ICD-KBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17274","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81422","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision constricting tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26596","description":"Excision constricting tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD0","description":"ICD-HIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB1","description":"ICD-DDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF1","description":"ICD-BEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD1","description":"ICD-GEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67930","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF0","description":"ICD-JHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrig cone/cath w brs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4399","description":"Ostomy irrig cone/cath w brs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB1","description":"ICD-CFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF1","description":"ICD-BDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB1","description":"ICD-OKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0522T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair ing hernia sliding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49525","description":"Repair ing hernia sliding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC1","description":"ICD-NJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC0","description":"ICD-OBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE0","description":"ICD-AEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF0","description":"ICD-OCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD1","description":"ICD-ECLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF1","description":"ICD-KENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA0","description":"ICD-NBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB0","description":"ICD-BFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurawrap nerve protector_cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9353","description":"Neurawrap nerve protector_cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33440","description":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess anginal symptom/level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1002F","description":"Assess anginal symptom/level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA0","description":"ICD-OARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81249","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth electroshock","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10451","description":"Anesth electroshock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC1","description":"ICD-AHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME0","description":"ICD-KCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE1","description":"ICD-JCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB1","description":"ICD-MJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC1","description":"ICD-BCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED1","description":"ICD-NCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1001T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","description":"CPT-1001T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28436","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50360","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0C","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90947","description":"Dialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6055","description":"Nicotine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","description":"CPT-92632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50974","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC1","description":"ICD-NFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF0","description":"ICD-BIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8911","description":"Mra w/o fol w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC0","description":"ICD-NJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB0","description":"ICD-CDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC0","description":"ICD-CFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medrsn no pt category","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9292","description":"Medrsn no pt category","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sheath upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8415","description":"Sheath upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB1","description":"ICD-IILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0575","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0575","description":"HCPCS-G0575","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA1","description":"ICD-AFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA1","description":"ICD-NCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF0","description":"ICD-CDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF0","description":"ICD-MKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF0","description":"ICD-MCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28288","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE1","description":"ICD-BHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE0","description":"ICD-BETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD0","description":"ICD-ABLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF0","description":"ICD-OKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meperidine hydrochl /100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2175","description":"Meperidine hydrochl /100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD1","description":"ICD-CISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD1","description":"ICD-ODCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD126","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Larynscop w/tumr exc + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31541","description":"Larynscop w/tumr exc + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD0","description":"ICD-CGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluid pressure muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20950","description":"Fluid pressure muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA1","description":"ICD-KGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD0","description":"ICD-BEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intens cardiac rehab w/exerc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0422","description":"Intens cardiac rehab w/exerc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC1","description":"ICD-CDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC1","description":"ICD-KBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA0","description":"ICD-GHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I125 iothalamate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9554","description":"I125 iothalamate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA0","description":"ICD-FIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF1","description":"ICD-CBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA0","description":"ICD-FFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4D","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC0","description":"ICD-BIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB0","description":"ICD-KABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC1","description":"ICD-JBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA1","description":"ICD-DBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8033","description":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE0","description":"ICD-KDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28360","description":"Reconstruct cleft foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA0","description":"ICD-NIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fo nontorsion joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3935","description":"Fo nontorsion joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","description":"HCPCS-M1438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB1","description":"ICD-KGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9913","description":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0901","description":"HCPCS-A0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD0","description":"ICD-HHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE1","description":"ICD-OEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA0","description":"ICD-OKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB156","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF1","description":"ICD-JCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent tobacco status is tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9791","description":"Most recent tobacco status is tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA56","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB1","description":"ICD-PESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD0","description":"ICD-FILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC1","description":"ICD-AELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB0","description":"ICD-OJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1069T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1069T","description":"CPT-1069T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef greater than 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3056F","description":"Lvef greater than 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0645U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0645U","description":"CPT-0645U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD1","description":"ICD-NBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flow cyto done b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3170F","description":"Flow cyto done b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE1","description":"ICD-KEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD0","description":"ICD-HCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","description":"HCPCS-Q4386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE1","description":"ICD-BDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43261","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1003","description":"HCPCS-A1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE1","description":"ICD-OIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF1","description":"ICD-OJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA205","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD1","description":"ICD-CGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE1","description":"ICD-NFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB0","description":"ICD-BGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laps impltj nstim vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312T","description":"Laps impltj nstim vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63198","description":"Incise spin&cord 2 stgs crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82541","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9269","description":"Injection_ tagraxofusp-erzs_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder universal joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6650","description":"Shoulder universal joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF1","description":"ICD-IACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0459","description":"Chest wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE0","description":"ICD-FIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67840","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB0","description":"ICD-OEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2386","description":"Foam filled drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC1","description":"ICD-KENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC1","description":"ICD-FCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA1","description":"ICD-BCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF0","description":"ICD-LHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62287","description":"Percutaneous diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC1","description":"ICD-CFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB0","description":"ICD-HGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX35","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2C","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED0","description":"ICD-GAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8880","description":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF1","description":"ICD-FITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB1","description":"ICD-GHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE1","description":"ICD-MKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF1","description":"ICD-CDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID0","description":"ICD-KIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC1","description":"ICD-OJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD1","description":"ICD-BIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15760","description":"Composite skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24925","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7505","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA1","description":"ICD-NFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC0","description":"ICD-OHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF0","description":"ICD-IBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE1","description":"ICD-PLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","description":"HCPCS-M1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38573","description":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA0","description":"ICD-OCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99459","description":"Pelvic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF0","description":"ICD-FDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin graft f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15155","description":"Cult skin graft f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB1","description":"ICD-KDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD0","description":"ICD-MBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE0","description":"ICD-BDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC1","description":"ICD-FCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB0","description":"ICD-JBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Isavuconazonium Sulfate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9456","description":"Injection_ Isavuconazonium Sulfate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9392","description":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE0","description":"ICD-NHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE0","description":"ICD-BIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF0","description":"ICD-OLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9973","description":"Epoetin beta_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kit gene analys d816 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81273","description":"Kit gene analys d816 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC1","description":"ICD-NLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"S&i stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076T","description":"S&i stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE0","description":"ICD-FEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB0","description":"ICD-OKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00948","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","description":"CPT-00948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF0","description":"ICD-OJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA0","description":"ICD-OHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC0","description":"ICD-NEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray spleen/liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75810","description":"Vein x-ray spleen/liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33400","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD0","description":"ICD-MFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3290","description":"HCPCS-J3290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77333","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD0","description":"ICD-IFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE1","description":"ICD-HDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA1","description":"ICD-NLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD0","description":"ICD-CBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tb ag response t-cell susp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86481","description":"Tb ag response t-cell susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID1","description":"ICD-OBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1165","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasonic generator w svneb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0574","description":"Ultrasonic generator w svneb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE1","description":"ICD-PCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA0","description":"ICD-OHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC1","description":"ICD-CGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC1","description":"ICD-LHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE1","description":"ICD-BCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit pain mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9325","description":"Hit pain mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB0","description":"ICD-KBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77767","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA1","description":"ICD-GCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9393","description":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD1","description":"ICD-JGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD0","description":"ICD-IETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE1","description":"ICD-CCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1202","description":"HCPCS-C1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB0","description":"ICD-BECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC0","description":"ICD-KCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD1","description":"ICD-BAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF0","description":"ICD-DCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vital signs recorded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2010F","description":"Vital signs recorded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE0","description":"ICD-JAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46280","description":"Remove anal fist complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA0","description":"ICD-MJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC1","description":"ICD-NBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF1","description":"ICD-JCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE0","description":"ICD-FBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD1","description":"ICD-OBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9991","description":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","description":"HCPCS-A2038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE1","description":"ICD-MEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE1","description":"ICD-BDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9793","description":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33512","description":"Cabg vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA1","description":"ICD-MGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC1","description":"ICD-BFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analysis tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88358","description":"Analysis tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0974T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","description":"CPT-0974T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB0","description":"ICD-OBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00750","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","description":"CPT-00750","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB1","description":"ICD-KECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87502","description":"Influenza dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC1","description":"ICD-OJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE0","description":"ICD-KDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic ring fracture uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0413","description":"Pelvic ring fracture uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54312","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA1","description":"ICD-NEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE1","description":"ICD-FBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped complete soy based","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4159","description":"Ef ped complete soy based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC0","description":"ICD-OBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57120","description":"Closure of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6074","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC0","description":"ICD-KCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35311","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9389","description":"Unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF1","description":"ICD-KAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bile duct revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47701","description":"Bile duct revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC1","description":"ICD-OIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB0","description":"ICD-IALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thera&Couns Svcs (Counseling Svcs)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0093","description":"Thera&Couns Svcs (Counseling Svcs)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF1","description":"ICD-GFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52270","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig neg scrn depres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8510","description":"Pt inelig neg scrn depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE0","description":"ICD-BIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Powered air mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0372","description":"Powered air mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA1","description":"ICD-JFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF1","description":"ICD-IBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE0","description":"ICD-CFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92613","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81508","description":"Ftl cgen abnor two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB1","description":"ICD-CHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA1","description":"ICD-KDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD0","description":"ICD-JBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9504","description":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Use of speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92609","description":"Use of speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia trachomatis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87270","description":"Chlamydia trachomatis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00561","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","description":"CPT-00561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD0","description":"ICD-KDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF1","description":"ICD-NAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43497","description":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electron beam computed tomog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8092","description":"Electron beam computed tomog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB21","description":"ICD-2KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28485","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48102","description":"Needle biopsy pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF1","description":"ICD-OEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0402","description":"HCPCS-B0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy balloon <30mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43220","description":"Esophagoscopy balloon <30mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9042","description":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB1","description":"ICD-OIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD1","description":"ICD-ACDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF0","description":"ICD-AFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone 20-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83499","description":"Assay of progesterone 20-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA1","description":"ICD-IGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB1","description":"ICD-GCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA1","description":"ICD-BCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Copd measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8898","description":"Copd measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breastpump lok ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4286","description":"Replcmnt breastpump lok ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hern recur comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49657","description":"Lap inc hern recur comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD1","description":"ICD-GDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED0","description":"ICD-AGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6404","description":"Sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD1","description":"ICD-HHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE1","description":"ICD-PDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal mets recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9098","description":"Onc dx esophageal mets recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME0","description":"ICD-EGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB0","description":"ICD-CBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spacer without mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8100","description":"Spacer without mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91315","description":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA1","description":"ICD-NBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED0","description":"ICD-EDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25670","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construction of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57291","description":"Construction of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD0","description":"ICD-OLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB1","description":"ICD-KGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening methadone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80358","description":"Drug screening methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ethosuximide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80168","description":"Assay of ethosuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE0","description":"ICD-BAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8531","description":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE0","description":"ICD-FHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB0","description":"ICD-DIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME1","description":"ICD-GEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45335","description":"Sigmoidoscopy w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile cefuroxime injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0697","description":"Sterile cefuroxime injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retinal tamp_ silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1814","description":"Retinal tamp_ silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99090","description":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44405","description":"Colonoscopy w/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB0","description":"ICD-FCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splint - extra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4323","description":"Splint - extra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21632","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"L hrt artery/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93458","description":"L hrt artery/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB1","description":"ICD-KBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA0","description":"ICD-BCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD0","description":"ICD-PJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB0","description":"ICD-JIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD0","description":"ICD-FCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28106","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD0","description":"ICD-LDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC1","description":"ICD-OHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD0","description":"ICD-KIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB0","description":"ICD-NCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF1","description":"ICD-DFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96161","description":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23472","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF1","description":"ICD-BDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID0","description":"ICD-MJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA25","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX34","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE1","description":"ICD-KDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27003","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB1","description":"ICD-MAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA0","description":"ICD-KGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB1","description":"ICD-CGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF0","description":"ICD-FBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tb test cell immun measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86480","description":"Tb test cell immun measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20962","description":"Other bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE1","description":"ICD-MCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB1","description":"ICD-JFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alginate drsg >16 <=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6197","description":"Alginate drsg >16 <=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE106","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB1","description":"ICD-FETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27884","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant drainage device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66183","description":"Insert ant drainage device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD1","description":"ICD-CHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27702","description":"Reconstruct ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amp no reqd in48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9639","description":"Amp no reqd in48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA1","description":"ICD-OKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","description":"CPT-01952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC1","description":"ICD-CADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA0","description":"ICD-AAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8039","description":"Breast prosthesis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9278","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","description":"HCPCS-J9278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34702","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB0","description":"ICD-ADUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE1","description":"ICD-FCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1703","description":"CDT-D1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF0","description":"ICD-GFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay thyroid stim hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84443","description":"Assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF0","description":"ICD-GHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-66683","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","description":"CPT-66683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD1","description":"ICD-OEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA1","description":"ICD-OIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26498","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sbrt management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77435","description":"Sbrt management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis rad/ul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3982","description":"Upper ext fx orthosis rad/ul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC0","description":"ICD-BEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot c antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85302","description":"Clot inhibit prot c antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC0","description":"ICD-AEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD0","description":"ICD-AGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim 6mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2505","description":"Injection_ pegfilgrastim 6mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66991","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt neurostim radiofq rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8682","description":"Implt neurostim radiofq rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE1","description":"ICD-FCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112U","description":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC0","description":"ICD-OJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hern premie blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49492","description":"Rpr ing hern premie blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rails w/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0290","description":"Hosp bed fx ht w/o rails w/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Swallow current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8996","description":"Swallow current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED0","description":"ICD-EGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE1","description":"ICD-MGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Misc sup/acc ext vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0507","description":"Misc sup/acc ext vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00410","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","description":"CPT-00410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD1","description":"ICD-IDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED0","description":"ICD-IAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA0","description":"ICD-OKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB224","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA0","description":"ICD-GGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intratubal occlusion device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4264","description":"Intratubal occlusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD0","description":"ICD-EFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC51","description":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24370","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC1","description":"ICD-CEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA0","description":"ICD-OHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI angio chest w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71555","description":"MRI angio chest w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX33","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF1","description":"ICD-FENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special supply_ nos waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2028","description":"Special supply_ nos waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB1","description":"ICD-GETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC0","description":"ICD-GHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC11","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC1","description":"ICD-LDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE0","description":"ICD-CISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46760","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF0","description":"ICD-IBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD1","description":"ICD-JBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE1","description":"ICD-ADCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE0","description":"ICD-BHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB1","description":"ICD-GBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF0","description":"ICD-ODJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC1","description":"ICD-MAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082A","description":"ADM SARSCV2 3MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB23","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA0","description":"ICD-CFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID1","description":"ICD-JBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC0","description":"ICD-ODNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB1","description":"ICD-AHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv vaccine pandemic im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90668","description":"Iiv vaccine pandemic im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF1","description":"ICD-FFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD1","description":"ICD-BDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51060","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA0","description":"ICD-FGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083A","description":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC0","description":"ICD-EBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF1","description":"ICD-BEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC1","description":"ICD-OGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24310","description":"Revision of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED0","description":"ICD-AIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE1","description":"ICD-NCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC1","description":"ICD-NJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54110","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE0","description":"ICD-CFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43651","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC1","description":"ICD-FFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB255","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE1","description":"ICD-JGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD0","description":"ICD-GBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE1","description":"ICD-GDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB1","description":"ICD-JEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA0","description":"ICD-IFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA1","description":"ICD-KCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC0","description":"ICD-ODPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9771","description":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC0","description":"ICD-KBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB1","description":"ICD-ADHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44155","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE1","description":"ICD-IIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD0","description":"ICD-MFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE0","description":"ICD-OJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX36","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE1","description":"ICD-KBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47540","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl bat t.e.n.s. own by pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4630","description":"Repl bat t.e.n.s. own by pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1353","description":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE1","description":"ICD-OJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9697","description":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"D & c after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59160","description":"D & c after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD0","description":"ICD-JGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0504","description":"CDT-D0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD0","description":"ICD-CIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE1","description":"ICD-IEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML51","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF1","description":"ICD-NEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA0","description":"ICD-NDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0983","description":"Add pwr joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA0","description":"ICD-MHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC1","description":"ICD-JGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF0","description":"ICD-CALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA0","description":"ICD-OKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444T","description":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF1","description":"ICD-CBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enlarge breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19324","description":"Enlarge breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA0","description":"ICD-HDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB0","description":"ICD-JHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF0","description":"ICD-GCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC20","description":"Very High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB1","description":"ICD-ADMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA31","description":"ICD-3IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB131","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC1","description":"ICD-MBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50434","description":"Convert nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF0","description":"ICD-OFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6241","description":"Bridge porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE1","description":"ICD-CFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF1","description":"ICD-OLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9310","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9310","description":"HCPCS-C9310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX46","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF0","description":"ICD-CEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF1","description":"ICD-OGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6910","description":"Hand restoration no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE1","description":"ICD-BDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6084","description":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC0","description":"ICD-AHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC0","description":"ICD-HEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0730T","description":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB1","description":"ICD-FGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC11","description":"ICD-2LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE0","description":"ICD-GEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB22","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA1","description":"ICD-OLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF0","description":"ICD-OGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL51","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF1","description":"ICD-AIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE1","description":"ICD-NEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD0","description":"ICD-IIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extra-oral posterior dental radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0705","description":"Extra-oral posterior dental radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37267","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","description":"CPT-37267","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB1","description":"ICD-OABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0538U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","description":"CPT-0538U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE1","description":"ICD-JDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Necropsy (autopsy) procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88099","description":"Necropsy (autopsy) procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA244","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81449","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB0","description":"ICD-JCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB31","description":"ICD-4DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA0","description":"ICD-GBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair valve femoral vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34501","description":"Repair valve femoral vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59852","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB07","description":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28465","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD0","description":"ICD-JCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31070","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC0","description":"ICD-CIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF0","description":"ICD-DCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD0","description":"ICD-JFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA1","description":"ICD-MDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derm-Maxx_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4238","description":"Derm-Maxx_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA1","description":"ICD-CACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1604","description":"HCPCS-A1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system liquid portabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0435","description":"Oxygen system liquid portabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29884","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC0","description":"ICD-IEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Voriconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80285","description":"Voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyclophosphamide 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9070","description":"Cyclophosphamide 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC1","description":"ICD-OCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft t/a/l addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15151","description":"Cult skin grft t/a/l addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1193","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE0","description":"ICD-OFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA0","description":"ICD-NENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj occipital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64405","description":"N block inj occipital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF0","description":"ICD-MHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54840","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64565","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9724","description":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0B","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF0","description":"ICD-PLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB0","description":"ICD-CBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal strict criteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89322","description":"Semen anal strict criteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF1","description":"ICD-KGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB1","description":"ICD-GENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC1","description":"ICD-CDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fld ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1234","description":"Fld ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE0","description":"ICD-BGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abd paracentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49082","description":"Abd paracentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE0","description":"ICD-FFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA0","description":"ICD-BBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE0","description":"ICD-ODTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59856","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA1","description":"ICD-GFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plan care lipid control docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556F","description":"Plan care lipid control docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF0","description":"ICD-OLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB0","description":"ICD-KBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC0","description":"ICD-GBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00546","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","description":"CPT-00546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC0","description":"ICD-GFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB0","description":"ICD-LBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38100","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27054","description":"Removal of hip joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ventricle muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33416","description":"Revise ventricle muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD0","description":"ICD-JIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC1","description":"ICD-OIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0565U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","description":"CPT-0565U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB0","description":"ICD-KBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE0","description":"ICD-CFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","description":"HCPCS-M1421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA0","description":"ICD-GASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF1","description":"ICD-GBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11602","description":"Exc tr-ext mal+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE1","description":"ICD-KINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF0","description":"ICD-GIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA0","description":"ICD-OILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9791","description":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD1","description":"ICD-OLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF0","description":"ICD-AIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appro rad ds dvcs techs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6040F","description":"Appro rad ds dvcs techs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB1","description":"ICD-NDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC1","description":"ICD-FDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7329","description":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB0","description":"ICD-FFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB1","description":"ICD-NLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pafolacianine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9603","description":"Injection_ pafolacianine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28291","description":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF0","description":"ICD-CBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74248","description":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID1","description":"ICD-IHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 2","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1782","description":"vaccine administration-human papillomavirus - Dose 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0735","description":"Non-invasive vagus nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26686","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA0","description":"ICD-KERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA0","description":"ICD-ECIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9969","description":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44020","description":"Explore small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","description":"HCPCS-A2031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atropine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7635","description":"Atropine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE0","description":"ICD-GBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92977","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD0","description":"ICD-PDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maternity care procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59899","description":"Maternity care procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA1","description":"ICD-JFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose and 0.45% saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5010","description":"5% dextrose and 0.45% saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA0","description":"ICD-NFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0658U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0658U","description":"CPT-0658U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF1","description":"ICD-NHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB1","description":"ICD-GHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA0","description":"ICD-BCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC1","description":"ICD-BBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs cran les complex addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61799","description":"Srs cran les complex addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF0","description":"ICD-IELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB1","description":"ICD-BDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD0","description":"ICD-BFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF0","description":"ICD-ODYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB02","description":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD0","description":"ICD-BCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterostomal therapy by a re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9474","description":"Enterostomal therapy by a re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD1","description":"ICD-BBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11401","description":"Exc tr-ext b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retrograde ejaculation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89331","description":"Retrograde ejaculation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12054","description":"Intmd rpr face/mm 7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2B","description":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glass/plastic slab off prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2710","description":"Glass/plastic slab off prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6527","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81357","description":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD0","description":"ICD-OGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD0","description":"ICD-NCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81194","description":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA1","description":"ICD-OCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB31","description":"ICD-1IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF1","description":"ICD-KBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF0","description":"ICD-DEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD1","description":"ICD-KGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48556","description":"Removal allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE1","description":"ICD-AHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/o fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21338","description":"Open nasoethmoid fx w/o fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD1","description":"ICD-GAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 3 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0399","description":"Home sleep test/type 3 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB0","description":"ICD-OIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69745","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental consultation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9310","description":"Dental consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD215","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB1","description":"ICD-OANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD0","description":"ICD-OJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0562T","description":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE0","description":"ICD-HIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF0","description":"ICD-IBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE0","description":"ICD-CGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD0","description":"ICD-JGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD1","description":"ICD-NGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA0","description":"ICD-CCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD0","description":"ICD-KHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82166","description":"Anti-mullerian hormone (AMH)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23605","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA0","description":"ICD-NKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE0","description":"ICD-FHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64681","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF1","description":"ICD-OGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE1","description":"ICD-FEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF0","description":"ICD-PAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC1","description":"ICD-JGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC1","description":"ICD-IIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA0","description":"ICD-GIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC1","description":"ICD-FGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE0","description":"ICD-NFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vasc graft into carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25430","description":"Vasc graft into carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD1","description":"ICD-HBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD1","description":"ICD-KIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA1","description":"ICD-KAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE0","description":"ICD-DEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA1","description":"ICD-OLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD0","description":"ICD-NAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF0","description":"ICD-FBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF0","description":"ICD-ODQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC0","description":"ICD-KHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC1","description":"ICD-BCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25676","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA0","description":"ICD-FEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62180","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC0","description":"ICD-KCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC0","description":"ICD-OKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE1","description":"ICD-KAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE0","description":"ICD-CHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft repair perimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6103","description":"Bone graft repair perimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Free/remove chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32320","description":"Free/remove chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid check both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92593","description":"Hearing aid check both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9549","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA0","description":"ICD-KHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulm fx w/in 12 mon b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3038F","description":"Pulm fx w/in 12 mon b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8H","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND1","description":"ICD-JEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant headset replace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8615","description":"Coch implant headset replace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis a igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86709","description":"Hepatitis a igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID0","description":"ICD-OIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF1","description":"ICD-ABCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9844","description":"Patient did not receive anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE0","description":"ICD-BFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE1","description":"ICD-PGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC0","description":"ICD-MHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacotherapy for OUD initiated after June 30th of performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1033","description":"Pharmacotherapy for OUD initiated after June 30th of performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB0","description":"ICD-NJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA0","description":"ICD-ABLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC0","description":"ICD-MEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE1","description":"ICD-GGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cervical traction equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0855","description":"Cervical traction equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD1","description":"ICD-CADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","description":"CPT-49190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC0","description":"ICD-MFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esano a_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4272","description":"Esano a_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID1","description":"ICD-BCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA34","description":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID0","description":"ICD-KGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ viltolarsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9071","description":"Injection_ viltolarsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1822","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","description":"HCPCS-E1822","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA1","description":"ICD-PJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE0","description":"ICD-EHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE1","description":"ICD-IGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE1","description":"ICD-OIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6454","description":"Self-adher band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9011","description":"Mccd_ risk adj_ level 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC0","description":"ICD-CIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF1","description":"ICD-JBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC0","description":"ICD-OIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza antibdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86684","description":"Hemophilus influenza antibdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl/idrl lsn any lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63290","description":"Bx/exc xdrl/idrl lsn any lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Malig tumor exc to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7440","description":"Malig tumor exc to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental film skull/facial bon","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0290","description":"Dental film skull/facial bon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA0","description":"ICD-OESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE0","description":"ICD-IDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD0","description":"ICD-ABMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME1","description":"ICD-MDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF1","description":"ICD-JBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE0","description":"ICD-CHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4346","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","description":"HCPCS-Q4346","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD1","description":"ICD-GCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lacosamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80235","description":"Lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA23","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket knee disarticula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5622","description":"Test socket knee disarticula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB1","description":"ICD-MJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA1","description":"ICD-GDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA0","description":"ICD-LCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43850","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84157","description":"Assay of protein other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA0","description":"ICD-IHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert vad art&vein access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33991","description":"Insert vad art&vein access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measure ureter pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50686","description":"Measure ureter pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No assess bone loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8863","description":"No assess bone loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA1","description":"ICD-MLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo radical prostatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55866","description":"Laparo radical prostatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56637","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0903T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","description":"CPT-0903T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD1","description":"ICD-KIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix/repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57555","description":"Remove cervix/repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE1","description":"ICD-GELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD244","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1101","description":"CDT-D1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD0","description":"ICD-BFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB1","description":"ICD-BAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6199","description":"Implant procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA1","description":"ICD-JIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE1","description":"ICD-KCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63270","description":"Excise intrspinl lesion crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient enrolled in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9858","description":"Patient enrolled in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair extra toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28344","description":"Repair extra toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427U","description":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA1","description":"ICD-FHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv/hib vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90698","description":"Dtap-ipv/hib vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64802","description":"Sympathectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4046","description":"Cast sup sht leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screen pap by tech w md supv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3000","description":"Screen pap by tech w md supv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF1","description":"ICD-LGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC1","description":"ICD-BGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA0","description":"ICD-BHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD1","description":"ICD-JFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB1","description":"ICD-GBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas iliac a device addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34808","description":"Endovas iliac a device addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69660","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45113","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB134","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/maint cont hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4890","description":"Repair/maint cont hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1640","description":"Hemin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4025","description":"Physical Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn for cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9264","description":"Docrsn for cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB0","description":"ICD-IIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA52","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1004","description":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD0","description":"ICD-OJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC1","description":"ICD-ODXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA0","description":"ICD-CAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shorten radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25392","description":"Shorten radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9313","description":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ golodirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1429","description":"Injection_ golodirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF1","description":"ICD-GHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD0","description":"ICD-GEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE231","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1443","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","description":"HCPCS-M1443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF1","description":"ICD-FHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27258","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE0","description":"ICD-HGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED0","description":"ICD-ACED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF1","description":"ICD-HAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81322","description":"Pten gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB0","description":"ICD-GHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX05","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gen_ neuro_ hf_ rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1822","description":"Gen_ neuro_ hf_ rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC0","description":"ICD-GCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF1","description":"ICD-GASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE0","description":"ICD-OISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33976","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA1","description":"ICD-JBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB0","description":"ICD-AEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD235","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD1","description":"ICD-LHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC1","description":"ICD-OIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB1","description":"ICD-NJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroplasty duodenal switch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43845","description":"Gastroplasty duodenal switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE201","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC1","description":"ICD-MDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA0","description":"ICD-LGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dispos cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0500","description":"Dispos cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC0","description":"ICD-OJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt pprom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9209","description":"Home mgmt pprom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC1","description":"ICD-CFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB0","description":"ICD-NBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC1","description":"ICD-GGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93315","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30520","description":"Repair of nasal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2004","description":"CDT-D2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33965","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD0","description":"ICD-NLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC0","description":"ICD-KFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric analy w/ph ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82930","description":"Gastric analy w/ph ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE1","description":"ICD-OIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61518","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA1","description":"ICD-BFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70380","description":"X-ray exam of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA1","description":"ICD-NETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD0","description":"ICD-BGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB0","description":"ICD-AIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67110","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA0","description":"ICD-PBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE1","description":"ICD-KBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult daycare services 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5100","description":"Adult daycare services 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID1","description":"ICD-JHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8668","description":"Fun stat score ue < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hast w/oxygen titrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94453","description":"Hast w/oxygen titrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Routine footcare pt w lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0247","description":"Routine footcare pt w lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cad meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8498","description":"Cad meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB1","description":"ICD-NGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC0","description":"ICD-EAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HER2/neu positive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9830","description":"HER2/neu positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable compressor filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7013","description":"Disposable compressor filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Man w/ch acc seat w>=20in<24in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2201","description":"Man w/ch acc seat w>=20in<24in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Moving Expenses)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7333","description":"Community Transition Svcs (Moving Expenses)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 1 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92315","description":"Rx cntact lens aphakia 1 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF1","description":"ICD-NJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE1","description":"ICD-FGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB1","description":"ICD-GHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA1","description":"ICD-FENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF0","description":"ICD-NJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD1","description":"ICD-KBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB1","description":"ICD-JATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2087","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86806","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB0","description":"ICD-GAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA0","description":"ICD-JGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0733","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed institutional t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0270","description":"Hospital bed institutional t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC0","description":"ICD-LFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID0","description":"ICD-KHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB0","description":"ICD-OIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00604","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","description":"CPT-00604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rec ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8506","description":"Pt rec ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB1","description":"ICD-BABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB1","description":"ICD-KDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC0","description":"ICD-BBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC124","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35901","description":"Excision graft neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thrombin time titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85675","description":"Thrombin time titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD0","description":"ICD-BGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/plcmt stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45347","description":"Sigmoidoscopy w/plcmt stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB0","description":"ICD-KIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED1","description":"ICD-NAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB1","description":"ICD-PEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophys map 3d add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93613","description":"Electrophys map 3d add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55150","description":"Removal of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF1","description":"ICD-NBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF1","description":"ICD-GBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95865","description":"Muscle test larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC117","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB255","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF1","description":"ICD-ADHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF1","description":"ICD-MGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","description":"CPT-01710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lorazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2060","description":"Lorazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA1","description":"ICD-MCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC07","description":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB1","description":"ICD-GDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB1","description":"ICD-KILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1710","description":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC0","description":"ICD-NJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC21","description":"ICD-2GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE1","description":"ICD-MLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfe gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81256","description":"Hfe gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF1","description":"ICD-MJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inc thyr node <1.0 in rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9552","description":"Inc thyr node <1.0 in rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9363","description":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81380","description":"Hla i typing 1 locus hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES205","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E3200","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","description":"HCPCS-E3200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp tibial-tib/peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35570","description":"Art byp tibial-tib/peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","description":"HCPCS-J7521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm adapt/boot couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5289","description":"Ald fm/dm adapt/boot couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27602","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC1","description":"ICD-GFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33513","description":"Cabg vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC0","description":"ICD-ICBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide cardiocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76930","description":"Echo guide cardiocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63650","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 5999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4726","description":"Dialys sol fld vol > 5999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No low pecarn ped head traum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9597","description":"No low pecarn ped head traum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB0","description":"ICD-JIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prehensile actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7040","description":"Prehensile actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No surg site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9311","description":"No surg site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA0","description":"ICD-BGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Posterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8000","description":"Posterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB60","description":"Low Rehab_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Waiver service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2025","description":"Waiver service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6218","description":"Non-sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0861","description":"Pwc gp3 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE0","description":"ICD-FECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 pentetreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9572","description":"Indium in-111 pentetreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA0","description":"ICD-BCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33750","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA1","description":"ICD-OLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was in hospice or receiving palliative care at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1059","description":"Patient was in hospice or receiving palliative care at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low- dose computed tomography for lung cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8032","description":"Low- dose computed tomography for lung cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp remove duct calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43264","description":"Ercp remove duct calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC0","description":"ICD-LAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF0","description":"ICD-OHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA1","description":"ICD-OHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58270","description":"Vag hyst w/enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF1","description":"ICD-PJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC1","description":"ICD-JINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB1","description":"ICD-FGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE1","description":"ICD-OIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF1","description":"ICD-CFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Azithromycin dihydrate_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0144","description":"Azithromycin dihydrate_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD0","description":"ICD-CCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clofarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9027","description":"Clofarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pentamidine iseth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0080","description":"Injection_ pentamidine iseth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD0","description":"ICD-OJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipid profile perf doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8725","description":"Lipid profile perf doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD131","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2120","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96137","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF0","description":"ICD-PDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy pouch solid deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4395","description":"Ostomy pouch solid deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD0","description":"ICD-JEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD1","description":"ICD-LFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reoperation bypass graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35700","description":"Reoperation bypass graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232U","description":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 1-4 ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64643","description":"Chemodenerv 1 extrem 1-4 ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of long arm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29065","description":"Application of long arm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD1","description":"ICD-LBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD0","description":"ICD-BBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE0","description":"ICD-JGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspiration orbital contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67415","description":"Aspiration orbital contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED1","description":"ICD-MAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0B","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA0","description":"ICD-ODLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA1","description":"ICD-PARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald for cochlear implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5273","description":"Ald for cochlear implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE0","description":"ICD-NLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58960","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD0","description":"ICD-FFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00542","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","description":"CPT-00542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF1","description":"ICD-CHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC1","description":"ICD-GBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE0","description":"ICD-CDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF0","description":"ICD-KHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90658","description":"Iiv3 vaccine 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA1","description":"ICD-IFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5127","description":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1402","description":"HCPCS-C1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF1","description":"ICD-FIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8658","description":"Fun stat score le not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67208","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC1","description":"ICD-KEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID0","description":"ICD-EIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2098","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27784","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1491","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","description":"HCPCS-M1491","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB0","description":"ICD-KGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Path consult intraop 1 bloc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88331","description":"Path consult intraop 1 bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD1","description":"ICD-NAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC1","description":"ICD-CBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD1","description":"ICD-GFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF0","description":"ICD-KCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD1","description":"ICD-FDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD1","description":"ICD-FEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0954","description":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip flexible cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5966","description":"Hip flexible cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD0","description":"ICD-GEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE0","description":"ICD-GCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8845","description":"Pos airway press prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Candida antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86628","description":"Candida antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC21","description":"ICD-4LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF0","description":"ICD-CFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE0","description":"ICD-JCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16372","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16372","description":"CPT-16372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB0","description":"ICD-OFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0A","description":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scleral lens liquid bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0515","description":"Scleral lens liquid bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC0","description":"ICD-OBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA0","description":"ICD-KFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyalomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4117","description":"Hyalomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj repair of joint disc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7852","description":"Tmj repair of joint disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cover eye w/membrane","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65778","description":"Cover eye w/membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC1","description":"ICD-FEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD0","description":"ICD-CAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC0","description":"ICD-KECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40831","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In Hospice Or Using Hospice Services During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2153","description":"In Hospice Or Using Hospice Services During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0790T","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE0","description":"ICD-GEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41115","description":"Excision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC204","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No f/u eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9563","description":"No f/u eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB1","description":"ICD-KIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA1","description":"ICD-OJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA0","description":"ICD-NHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC1","description":"ICD-FDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE1","description":"ICD-GBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC31","description":"ICD-1GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0539T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB1","description":"ICD-LFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow fair lead cable dir fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6586","description":"Elbow fair lead cable dir fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0D","description":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA1","description":"ICD-ODOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE1","description":"ICD-EEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF0","description":"ICD-GAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE1","description":"ICD-HAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1134","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1097","description":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj naloxone hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2310","description":"Inj naloxone hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7510","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB1","description":"ICD-CFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB1","description":"ICD-AECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gatifloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1590","description":"Gatifloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","description":"HCPCS-J0165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1357","description":"Battery charger_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC1","description":"ICD-MKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF0","description":"ICD-MFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC1","description":"ICD-HEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA0","description":"ICD-KEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA0","description":"ICD-LGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF1","description":"ICD-NIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA1","description":"ICD-GDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preorthodontic tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8660","description":"Preorthodontic tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE1","description":"ICD-FFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ana crown exp 4 or> per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4230","description":"Ana crown exp 4 or> per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB0","description":"ICD-FHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78201","description":"Liver imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL36","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF1","description":"ICD-GAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA1","description":"ICD-OBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA0","description":"ICD-KGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","description":"CPT-97007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36513","description":"Apheresis platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78205","description":"Liver imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB0","description":"ICD-CCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0645T","description":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0516","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egfr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81235","description":"Egfr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB0","description":"ICD-IIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laps rmvl nstim array vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313T","description":"Laps rmvl nstim array vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF1","description":"ICD-JBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF0","description":"ICD-FDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE0","description":"ICD-FEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC0","description":"ICD-IEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-imaging heart function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78414","description":"Non-imaging heart function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF0","description":"ICD-NEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC1","description":"ICD-HDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB1","description":"ICD-EEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC1","description":"ICD-CIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Lefamulin (Xenleta)_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9054","description":"Injection_ Lefamulin (Xenleta)_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC0","description":"ICD-NHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45378","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF1","description":"ICD-GEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-programble infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0782","description":"Non-programble infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB0","description":"ICD-CEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID1","description":"ICD-CGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43621","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE1","description":"ICD-KBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD1","description":"ICD-NGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water seal drain container","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7041","description":"Water seal drain container","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC0","description":"ICD-OLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93241","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC0","description":"ICD-CANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC1","description":"ICD-OAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty w/cp bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33403","description":"Valvuloplasty w/cp bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revsc opn/prq tib/pero stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37234","description":"Revsc opn/prq tib/pero stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB0","description":"ICD-OBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"J-cell batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4234","description":"J-cell batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA0","description":"ICD-NBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED0","description":"ICD-FIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD1","description":"ICD-KIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD106","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA0","description":"ICD-GEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB1","description":"ICD-PDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85460","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64719","description":"Revise ulnar nerve at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD0","description":"ICD-GDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD235","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD1","description":"ICD-ADHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9516","description":"Iodine i-123 sod iodide mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE1","description":"ICD-GCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0115U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6571","description":"Gradient compression garment_ genital region_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME1","description":"ICD-AGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED1","description":"ICD-MFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA60","description":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PreTRM®_ Sera Prognostics_ Sera Prognostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0247U","description":"PreTRM®_ Sera Prognostics_ Sera Prognostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD1","description":"ICD-HHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0506U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","description":"CPT-0506U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF1","description":"ICD-GITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoro exam of g/colon tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49465","description":"Fluoro exam of g/colon tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain breast lesion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19001","description":"Drain breast lesion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo intralesional up to 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96405","description":"Chemo intralesional up to 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE0","description":"ICD-IHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25150","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1002","description":"HCPCS-B1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC0","description":"ICD-NJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC1","description":"ICD-GDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo by both infusion and o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0085","description":"Chemo by both infusion and o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE0","description":"ICD-KFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ceruloplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82390","description":"Assay of ceruloplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1077T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1077T","description":"CPT-1077T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC1","description":"ICD-OETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC0","description":"ICD-BHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13151","description":"Cmplx rpr e/n/e/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC1","description":"ICD-OEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB0","description":"ICD-GBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Loxapine_ inhalation powder_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9497","description":"Loxapine_ inhalation powder_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC1","description":"ICD-IFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78320","description":"Bone imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC1","description":"ICD-CECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD0","description":"ICD-BBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC54","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC1","description":"ICD-CIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89281","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF0","description":"ICD-KGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orthosis trilat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1720","description":"Legg perthes orthosis trilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF1","description":"ICD-JDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE1","description":"ICD-HBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC0","description":"ICD-GENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluorine-18 fluorodeoxygluco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8085","description":"Fluorine-18 fluorodeoxygluco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin graft t/a/l +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15152","description":"Cult skin graft t/a/l +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC1","description":"ICD-JEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue mouth neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41153","description":"Tongue mouth neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0627T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE0","description":"ICD-OBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA0","description":"ICD-CGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9600","description":"Perc drug-el cor stent sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67903","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69540","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE0","description":"ICD-ECDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC1","description":"ICD-NINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE0","description":"ICD-CAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular fomivirsen na","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1452","description":"Intraocular fomivirsen na","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0687","description":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB0","description":"ICD-JBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC1","description":"ICD-CGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA0","description":"ICD-JATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB0","description":"ICD-GFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81520","description":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC1","description":"ICD-FEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF1","description":"ICD-CCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD0","description":"ICD-HEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE0","description":"ICD-AECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0682U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682U","description":"CPT-0682U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0621","description":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF0","description":"ICD-NJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD1","description":"ICD-CAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61539","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3398","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA1","description":"ICD-PDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF0","description":"ICD-ECTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4346","description":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative screen metals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83018","description":"Quantitative screen metals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD1","description":"ICD-FEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99341","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25100","description":"Biopsy of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86364","description":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC1","description":"ICD-OLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC1","description":"ICD-FCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90626","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE0","description":"ICD-BCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA231","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65210","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE1","description":"ICD-FDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF0","description":"ICD-BHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD1","description":"ICD-IALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Donor pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48550","description":"Donor pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA0","description":"ICD-JEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF0","description":"ICD-JIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME1","description":"ICD-NAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE0","description":"ICD-DFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC0","description":"ICD-IITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC55","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90296","description":"Diphtheria antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE0","description":"ICD-KEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE1","description":"ICD-DGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45327","description":"Proctosigmoidoscopy w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB1","description":"ICD-KHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD1","description":"ICD-MKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015M","description":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD1","description":"ICD-NKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12020","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE1","description":"ICD-JGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27632","description":"Exc leg/ankle les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8602","description":"No tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD1","description":"ICD-LBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hbv assess&results intrp 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3517F","description":"Hbv assess&results intrp 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9258","description":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE0","description":"ICD-JBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA0","description":"ICD-KBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD0","description":"ICD-OLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA1","description":"ICD-EFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59620","description":"Attempted vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42300","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF0","description":"ICD-CDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC0","description":"ICD-GHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7614","description":"Levalbuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial preventive exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0402","description":"Initial preventive exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB0","description":"ICD-GBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA1","description":"ICD-CFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB1","description":"ICD-CFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64640","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand held low vision aids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2600","description":"Hand held low vision aids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF1","description":"ICD-FABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC1","description":"ICD-OJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48152","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF1","description":"ICD-IHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE1","description":"ICD-EECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA1","description":"ICD-OFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA0","description":"ICD-OCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88307","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE0","description":"ICD-KCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB1","description":"ICD-GGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bath/shower chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0240","description":"Bath/shower chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA1","description":"ICD-NKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1091T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1091T","description":"CPT-1091T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA0","description":"ICD-OHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/irrigate tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68840","description":"Explore/irrigate tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensv oral eval prob focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0160","description":"Extensv oral eval prob focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF0","description":"ICD-BCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza a ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87276","description":"Influenza a ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA240","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB1","description":"ICD-KHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","description":"CPT-97009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD1","description":"ICD-HCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0787T","description":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev resin rest_ perm tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1352","description":"Prev resin rest_ perm tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Warfrn or othr antcog no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8971","description":"Warfrn or othr antcog no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF1","description":"ICD-HBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87336","description":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC1","description":"ICD-NGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF0","description":"ICD-JGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA1","description":"ICD-OGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE0","description":"ICD-BIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ticarcillin disod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0040","description":"Injection_ ticarcillin disod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464T","description":"Visual evoked potential_ testing for glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD0","description":"ICD-LFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88305","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1306","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF1","description":"ICD-JIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50760","description":"Fusion of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB1","description":"ICD-DEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caries susceptibility test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0425","description":"Caries susceptibility test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0997T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","description":"CPT-0997T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ny heart assoc class docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3118F","description":"Ny heart assoc class docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB0","description":"ICD-KDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hib prp-t vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90648","description":"Hib prp-t vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg filler paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6240","description":"Hydrocolld drg filler paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78433","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt adheres guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9056","description":"Onc prac mgmt adheres guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD1","description":"ICD-CDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57310","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA1","description":"ICD-FFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF1","description":"ICD-FGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Robot lin-radsurg com_ first","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0339","description":"Robot lin-radsurg com_ first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC0","description":"ICD-OAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB1","description":"ICD-JFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME1","description":"ICD-MEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA0","description":"ICD-GHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1485","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","description":"HCPCS-M1485","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA0","description":"ICD-MIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90953","description":"Esrd serv 1 visit p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB1","description":"ICD-GFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3347","description":"Retreat root canal bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27218","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3D","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC0","description":"ICD-CHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD0","description":"ICD-CGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD0","description":"ICD-CHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA1","description":"ICD-OCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31623","description":"Dx bronchoscope/brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC1","description":"ICD-EILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD0","description":"ICD-BBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL34","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA0","description":"ICD-CFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","description":"HCPCS-G0569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ocriplasmin_ 0.125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7316","description":"Inj_ ocriplasmin_ 0.125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC1","description":"ICD-NATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01958","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","description":"CPT-01958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87903","description":"Phenotype dna hiv w/culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ pheresis_ pathogen-reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9073","description":"Platelets_ pheresis_ pathogen-reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal smear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65430","description":"Corneal smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB0","description":"ICD-NATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB0","description":"ICD-FDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB1","description":"ICD-CCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","description":"CPT-00160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant not specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80338","description":"Antidepressant not specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE145","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB0","description":"ICD-BBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB1","description":"ICD-JEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auricular replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5927","description":"Auricular replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA1","description":"ICD-NLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB1","description":"ICD-FCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy ureterolithotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50945","description":"Laparoscopy ureterolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE1","description":"ICD-NBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69633","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33362","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dxa ordered for osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8861","description":"Dxa ordered for osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cbc without platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0307","description":"Cbc without platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC217","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE1","description":"ICD-OLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64624","description":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC0","description":"ICD-FGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9169","description":"HCPCS-C9169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC0","description":"ICD-DBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD1","description":"ICD-JHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC0","description":"ICD-PIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC1","description":"ICD-GIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD1","description":"ICD-KFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB0","description":"ICD-FALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77772","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with dementia any time during the patient_s history through the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1164","description":"Patients with dementia any time during the patient_s history through the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF0","description":"ICD-GHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB0","description":"ICD-KHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Head/extremity control inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2328","description":"Head/extremity control inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE0","description":"ICD-ODAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA0","description":"ICD-NKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Etoposide oral 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8560","description":"Etoposide oral 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0130U","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67916","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11442","description":"Exc face-mm b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA1","description":"ICD-DDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC0","description":"ICD-GBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optimal care for kidney health mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0002","description":"Optimal care for kidney health mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE0","description":"ICD-KGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE0","description":"ICD-KCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF0","description":"ICD-MHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain thigh/knee lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27301","description":"Drain thigh/knee lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE1","description":"ICD-KEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace foot drop spint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4394","description":"Replace foot drop spint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE0","description":"ICD-CINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE0","description":"ICD-KGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA1","description":"ICD-FITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4347","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","description":"HCPCS-Q4347","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB1","description":"ICD-GIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE1","description":"ICD-DHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED0","description":"ICD-CEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt tlk psych & rx opd addic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4306F","description":"Pt tlk psych & rx opd addic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0807","description":"Pov group 2 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","description":"HCPCS-Q4405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE0","description":"ICD-NBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Planar seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2292","description":"Planar seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy remove myoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58561","description":"Hysteroscopy remove myoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevate footrest articulate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0053","description":"Elevate footrest articulate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3921","description":"Hfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD0","description":"ICD-OKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8G","description":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED1","description":"ICD-JFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC0","description":"ICD-CCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2061","description":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC0","description":"ICD-GCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methyl aminolevulinate_ top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7309","description":"Methyl aminolevulinate_ top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB1","description":"ICD-BEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE1","description":"ICD-MIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA1","description":"ICD-NAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF1","description":"ICD-LGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7214","description":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA1","description":"ICD-KAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9990","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD1","description":"ICD-PBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27403","description":"Repair of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atropine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0461","description":"Atropine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD131","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB1","description":"ICD-NFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE1","description":"ICD-KDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC0","description":"ICD-LCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95833","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB0","description":"ICD-IFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB1","description":"ICD-CBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF0","description":"ICD-OCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE1","description":"ICD-MBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF0","description":"ICD-OCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1191","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD1","description":"ICD-BILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0A","description":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF0","description":"ICD-GDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB0","description":"ICD-LCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB1","description":"ICD-NLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF1","description":"ICD-JFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD1","description":"ICD-OECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31296","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE0","description":"ICD-KGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ dual focus_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2525","description":"Contact lens_ hydrophilic_ dual focus_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD1","description":"ICD-FHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA0","description":"ICD-GESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF0","description":"ICD-IDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 4 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95133","description":"Immntx 4 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE1","description":"ICD-CEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC1","description":"ICD-NAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance cusfab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0486","description":"Oral device/appliance cusfab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reusable oral thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4931","description":"Reusable oral thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mens shoes hightop depth inl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3222","description":"Mens shoes hightop depth inl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF0","description":"ICD-KBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0825","description":"Pwc gp 2 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14000","description":"Tis trnfr trunk 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision hyperplastic tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7970","description":"Excision hyperplastic tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA1","description":"ICD-PBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC1","description":"ICD-OKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30469","description":"Repair of nasal valve collapse with low energy_ temperature-controlled (ie_ radiofrequency) subcutaneous/submucosal remodeling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC56","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd w/transmural drain cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43240","description":"Egd w/transmural drain cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2A","description":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal care atrisk assessm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1000","description":"Prenatal care atrisk assessm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC1","description":"ICD-KGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh new pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0469","description":"Fqhc visit_ mh new pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA1","description":"ICD-NIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC1","description":"ICD-GHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post-operative body jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1310","description":"Post-operative body jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD1","description":"ICD-MLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA1","description":"ICD-OAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID0","description":"ICD-CDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA0","description":"ICD-KHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic silesian ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5698","description":"Ak/knee disartic silesian ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA0","description":"ICD-JICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB25","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radial keratotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65771","description":"Radial keratotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC31","description":"ICD-3BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC1","description":"ICD-JAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29806","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36571","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA0","description":"ICD-NJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB0","description":"ICD-ODCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA0","description":"ICD-FCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8699","description":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331U","description":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB0","description":"ICD-OJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE0","description":"ICD-NEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB0","description":"ICD-GCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0937T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","description":"CPT-0937T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ inf_ per/cent/midline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1751","description":"Cath_ inf_ per/cent/midline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjv hrmnl thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4164F","description":"Adjv hrmnl thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair prosth valve clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33496","description":"Repair prosth valve clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC0","description":"ICD-EDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF0","description":"ICD-MDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA1","description":"ICD-EFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9591","description":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alginate drsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6199","description":"Alginate drsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF0","description":"ICD-NCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF0","description":"ICD-CHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy intraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57283","description":"Colpopexy intraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE1","description":"ICD-GDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36010","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2063","description":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1401","description":"HCPCS-C1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc w ami s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9606","description":"Perc d-e cor revasc w ami s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB1","description":"ICD-OBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart symp image plnr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331T","description":"Heart symp image plnr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID1","description":"ICD-CIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb plaster molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5510","description":"Prep bk ptb plaster molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple family group psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90849","description":"Multiple family group psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advnc care plan in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1157F","description":"Advnc care plan in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atten d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9167","description":"Atten d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 19-9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86301","description":"Immunoassay tumor ca 19-9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE1","description":"ICD-GGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61000","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB1","description":"ICD-JBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tendon & muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23405","description":"Incision of tendon & muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61864","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC1","description":"ICD-DESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE0","description":"ICD-EIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy inner cannula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4623","description":"Tracheostomy inner cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7610","description":"Albuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC0","description":"ICD-IFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1381","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","description":"HCPCS-M1381","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND0","description":"ICD-JDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg sacrococ teratoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2405","description":"Fetal surg sacrococ teratoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8E","description":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222T","description":"Plmt post facet implt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microsurgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69990","description":"Microsurgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9893","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF1","description":"ICD-JHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA0","description":"ICD-PCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA1","description":"ICD-FEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC0","description":"ICD-CEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA1","description":"ICD-CGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE1","description":"ICD-AGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8I","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc viral load >=200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9242","description":"Doc viral load >=200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC1","description":"ICD-KCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA0","description":"ICD-MGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-53866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","description":"CPT-53866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB0","description":"ICD-IDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sing fre stirr thi/calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2000","description":"Kafo sing fre stirr thi/calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of horseshoe kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50540","description":"Revision of horseshoe kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye socket wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65290","description":"Repair of eye socket wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Omnicardiogram/cardiointegra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9025","description":"Omnicardiogram/cardiointegra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - occlusal radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0706","description":"Intraoral - occlusal radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw w/advance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21199","description":"Reconstr lwr jaw w/advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1185","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA1","description":"ICD-KDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF1","description":"ICD-BHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB1","description":"ICD-FHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate leg veins radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37760","description":"Ligate leg veins radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF1","description":"ICD-BFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF0","description":"ICD-CIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2030","description":"Mh clubhouse svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruct premalg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17000","description":"Destruct premalg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest cultured skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15040","description":"Harvest cultured skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB1","description":"ICD-KBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Buccal/labial frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7961","description":"Buccal/labial frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD1","description":"ICD-KBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9486","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE0","description":"ICD-NBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA1","description":"ICD-CBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of torus palatinus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7472","description":"Removal of torus palatinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31582","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1021","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9070","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB0","description":"ICD-HBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65286","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion bil rot straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2040","description":"Hkafo torsion bil rot straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC111","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE1","description":"ICD-KFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA1","description":"ICD-MKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - periapical radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0374","description":"intraoral tomosynthesis - periapical radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB0","description":"ICD-ACUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC0","description":"ICD-FDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Granulocytes_ pheresis unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9050","description":"Granulocytes_ pheresis unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25115","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA0","description":"ICD-IDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD1","description":"ICD-MEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA0","description":"ICD-MCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6236","description":"Hydrocolld drg > 48 in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant semi-imp hear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2230","description":"Implant semi-imp hear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafix Core and GrafixPL Core_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4132","description":"Grafix Core and GrafixPL Core_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB1","description":"ICD-EFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion 7-12 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22802","description":"Post fusion 7-12 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC0","description":"ICD-FDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB1","description":"ICD-DIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD0","description":"ICD-BEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2A","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2311","description":"Lens sphc trifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43633","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE1","description":"ICD-KHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC1","description":"ICD-ADUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1389","description":"HCPCS-M1389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE0","description":"ICD-JFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lanreotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1930","description":"Lanreotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF0","description":"ICD-MIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD0","description":"ICD-BEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4225","description":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8X","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ std","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4087","description":"Gastro/jejuno tube_ std","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC1","description":"ICD-OCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB0","description":"ICD-DEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF0","description":"ICD-NBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81471","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE0","description":"ICD-FFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC1","description":"ICD-OCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonvascular shunt x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75809","description":"Nonvascular shunt x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB0","description":"ICD-NCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC0","description":"ICD-MKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB1","description":"ICD-OCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD1","description":"ICD-KCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA1","description":"ICD-IBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD0","description":"ICD-OEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual therapy 1/> regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97140","description":"Manual therapy 1/> regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23675","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85366","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD1","description":"ICD-PJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE0","description":"ICD-ECLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF1","description":"ICD-AEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve/shorten bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64876","description":"Repair nerve/shorten bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB0","description":"ICD-FHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA1","description":"ICD-NHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50957","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6609","description":"Gradient compression bandaging supply_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64858","description":"Repair sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Felbamate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80167","description":"Felbamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF1","description":"ICD-KHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0572U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","description":"CPT-0572U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB31","description":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC0","description":"ICD-FFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF0","description":"ICD-FGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF1","description":"ICD-FGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA0","description":"ICD-PASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD1","description":"ICD-GFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5180","description":"Hearing aid_ CROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF0","description":"ICD-IFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0541U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","description":"CPT-0541U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE0","description":"ICD-EGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hib-mency vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90644","description":"Hib-mency vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC0","description":"ICD-IHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hair analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2031","description":"Hair analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lubricant per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4402","description":"Lubricant per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0318","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD1","description":"ICD-FGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA1","description":"ICD-MAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA1","description":"ICD-NHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX43","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Routine venipuncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36415","description":"Routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB0","description":"ICD-OADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD0","description":"ICD-MDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7176","description":"HCPCS-J7176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aprotonin_ 10_000 kiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0365","description":"Aprotonin_ 10_000 kiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5647","description":"Below knee suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication & fitting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2628","description":"Fabrication & fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA1","description":"ICD-BBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC0","description":"ICD-BEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95832","description":"Hand muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ivig non-lyophilized_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1599","description":"Ivig non-lyophilized_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD0","description":"ICD-ABTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF1","description":"ICD-MITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA0","description":"ICD-OBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protein western blot tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88371","description":"Protein western blot tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9131","description":"Onc dx brst unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Oncology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4031","description":"Radiation Oncology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Z7610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Z7610","description":"HCPCS-Z7610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1mg (Varubi)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9981","description":"Rolapitant_ oral_ 1mg (Varubi)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE1","description":"ICD-OHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC0","description":"ICD-ICTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE1","description":"ICD-OIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63280","description":"Bx/exc idrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA1","description":"ICD-NECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse/graft added joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26863","description":"Fuse/graft added joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA0","description":"ICD-FANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD135","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69801","description":"Incise inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0981","description":"Seat upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB0","description":"ICD-DASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm est 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99606","description":"Mtms by pharm est 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1002T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","description":"CPT-1002T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther behav svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2020","description":"Ther behav svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC0","description":"ICD-OFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9154","description":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sho insert w arch toe filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5000","description":"Sho insert w arch toe filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA1","description":"ICD-AECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC1","description":"ICD-AFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD1","description":"ICD-JIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1061","description":"Patient pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33951","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD0","description":"ICD-EIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD1","description":"ICD-ADMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elliotts b solution per ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9175","description":"Elliotts b solution per ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty control cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6660","description":"Heavy duty control cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB0","description":"ICD-LAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27712","description":"Realignment of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD0","description":"ICD-GACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND0","description":"ICD-CBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE1","description":"ICD-NBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF0","description":"ICD-JFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leptospira antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86720","description":"Leptospira antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC0","description":"ICD-NHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE1","description":"ICD-GGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","description":"HCPCS-M1405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA0","description":"ICD-NHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33504","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0223","description":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD0","description":"ICD-LHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB0","description":"ICD-BFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press not prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8853","description":"Pos air press not prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE0","description":"ICD-GGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB0","description":"ICD-OHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF0","description":"ICD-OBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF0","description":"ICD-IFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87351","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 not assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9396","description":"Ini phq9 >9 not assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0871T","description":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA0","description":"ICD-FCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF0","description":"ICD-ODHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA0","description":"ICD-BHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF0","description":"ICD-IFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB1","description":"ICD-HERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF0","description":"ICD-BGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v =/> 1.2 & <1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3083F","description":"Kt/v =/> 1.2 & <1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA1","description":"ICD-OEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inlay composite/resin two su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2651","description":"Inlay composite/resin two su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA0","description":"ICD-CDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0227U","description":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB1","description":"ICD-CAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21296","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC1","description":"ICD-EHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28122","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE101","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA1","description":"ICD-OKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD0","description":"ICD-PKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 6-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87506","description":"Iadna-dna/rna probe tq 6-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD0","description":"ICD-JHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE1","description":"ICD-CFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of imperforated anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46742","description":"Repair of imperforated anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE0","description":"ICD-CACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE1","description":"ICD-IEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB1","description":"ICD-GGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD150","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD126","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC0","description":"ICD-KIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA0","description":"ICD-NIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9605","description":"Perc d-e cor revasc t cabg b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"American amnion ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4306","description":"American amnion ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1C","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00326","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","description":"CPT-00326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28052","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB0","description":"ICD-OKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1003T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","description":"CPT-1003T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA1","description":"ICD-JDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD0","description":"ICD-AACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX26","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB1","description":"ICD-GCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE0","description":"ICD-GENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB1","description":"ICD-GCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA1","description":"ICD-PISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD246","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot plate molded stirrup at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2250","description":"Foot plate molded stirrup at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME0","description":"ICD-OLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80341","description":"Antiepileptics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB1","description":"ICD-GHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE1","description":"ICD-AGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clozapine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0136","description":"Clozapine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE0","description":"ICD-OBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC1","description":"ICD-HIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB0","description":"ICD-OFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC1","description":"ICD-NKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD0","description":"ICD-NLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC1","description":"ICD-ICTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of ankle and/or ft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29540","description":"Strapping of ankle and/or ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alatrofloxacin mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0200","description":"Alatrofloxacin mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA1","description":"ICD-IHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8X","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB0","description":"ICD-BHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA0","description":"ICD-AEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel gear repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2369","description":"Pwr wc drivewheel gear repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID0","description":"ICD-KCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2721","description":"Crown resin w/ base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67314","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE1","description":"ICD-NFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB0","description":"ICD-GDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC1","description":"ICD-FBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE0","description":"ICD-NIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6537","description":"Gc stocking full lngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim no prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95970","description":"Analyze neurostim no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB1","description":"ICD-KARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood fungus culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87103","description":"Blood fungus culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA0","description":"ICD-OIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD0","description":"ICD-CAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF0","description":"ICD-KHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB0","description":"ICD-EHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC0","description":"ICD-NLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291U","description":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD1","description":"ICD-DFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temperature gradient studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93740","description":"Temperature gradient studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","description":"HCPCS-G0570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD0","description":"ICD-CILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD1","description":"ICD-KBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD0","description":"ICD-BFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD0","description":"ICD-OLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3550F","description":"Low rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA0","description":"ICD-BGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Emergency Pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1762","description":"Home Delivered Meals-Emergency Pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA0","description":"ICD-EGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB1","description":"ICD-GISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF1","description":"ICD-BBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE1","description":"ICD-PLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9741","description":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage ext line_ dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4672","description":"Drainage ext line_ dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3247","description":"Injection_ secukinumab_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4239","description":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apnea monitor w recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0619","description":"Apnea monitor w recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eyelid fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67715","description":"Incision of eyelid fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63267","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD0","description":"ICD-PAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA1","description":"ICD-FBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc elder mal scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8536","description":"No doc elder mal scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA1","description":"ICD-CHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE1","description":"ICD-GBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1102","description":"HCPCS-A1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA0","description":"ICD-MKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB0","description":"ICD-EHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Report ckd measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8487","description":"Report ckd measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF0","description":"ICD-NCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC0","description":"ICD-JCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision orbitofacial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21275","description":"Revision orbitofacial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE1","description":"ICD-HDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemorrhoidopexy by stapling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46947","description":"Hemorrhoidopexy by stapling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ketorolac tromethamine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1885","description":"Ketorolac tromethamine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC1","description":"ICD-AEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumizyme injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0221","description":"Lumizyme injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA1","description":"ICD-KGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52647","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0627","description":"Lo sag ri an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA21","description":"ICD-1AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD0","description":"ICD-PIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng glucoco thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4192F","description":"Pt not rcvng glucoco thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj octafluoropropane mic_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9956","description":"Inj octafluoropropane mic_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81193","description":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC1","description":"ICD-KFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2050","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2050","description":"HCPCS-A2050","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ank symes mold sckt sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5050","description":"Ank symes mold sckt sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB1","description":"ICD-BAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagomyotomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43331","description":"Esophagomyotomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB1","description":"ICD-JBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD1","description":"ICD-KGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF0","description":"ICD-CFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD0","description":"ICD-DBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57460","description":"Bx of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA1","description":"ICD-MBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI brain done 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3112F","description":"CT/MRI brain done 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00792","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","description":"CPT-00792","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB1","description":"ICD-JBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC0","description":"ICD-FGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0491","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB0","description":"ICD-BEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8X","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17276","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF0","description":"ICD-KHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67909","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toxoplasma antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86778","description":"Toxoplasma antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC1","description":"ICD-CCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID0","description":"ICD-CFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC0","description":"ICD-JDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5550","description":"Insulin rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC246","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB255","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29882","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB0","description":"ICD-ADBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Disposable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4437","description":"Irrigation Supply; Sleeve_ Disposable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB0","description":"ICD-BDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC0","description":"ICD-GASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF1","description":"ICD-PGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serv part of phase i trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9988","description":"Serv part of phase i trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD1","description":"ICD-AHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscopic fnb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45392","description":"Colonoscopy w/endoscopic fnb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trichogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96902","description":"Trichogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA0","description":"ICD-GIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 20 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9046","description":"Albumin (human)_ 25%_ 20 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5248","description":"Hearing aid_ binaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB0","description":"ICD-EDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB1","description":"ICD-KFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE0","description":"ICD-CDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE0","description":"ICD-FBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD0","description":"ICD-KDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst metastic/ recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9075","description":"Onc dx brst metastic/ recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31628","description":"Bronchoscopy/lung bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF0","description":"ICD-NHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us transrectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76872","description":"Us transrectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidural lysis mult sessions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62263","description":"Epidural lysis mult sessions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE0","description":"ICD-ABCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF1","description":"ICD-OIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5C","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE154","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood split unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9011","description":"Blood split unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95958","description":"Eeg monitoring/function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 1st dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0249","description":"Adm Tocilizu COVID-19 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low extemity neur not perfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8405","description":"Low extemity neur not perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD1","description":"ICD-KAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC1","description":"ICD-FFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB0","description":"ICD-BBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC0","description":"ICD-PDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF1","description":"ICD-MHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA1","description":"ICD-HERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open drainage liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47010","description":"Open drainage liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9126","description":"Hospice care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD0","description":"ICD-OHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB1","description":"ICD-FIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB1","description":"ICD-EAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE1","description":"ICD-IHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID0","description":"ICD-NCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy ligate perf veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37500","description":"Endoscopy ligate perf veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE1","description":"ICD-AICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE1","description":"ICD-PHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy islet cell trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0342","description":"Laparoscopy islet cell trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25505","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam&tx estab pt 1/>vst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92014","description":"Eye exam&tx estab pt 1/>vst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA0","description":"ICD-CBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC0","description":"ICD-OGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ovine_ 1000 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3472","description":"Ovine_ 1000 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE1","description":"ICD-CDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA1","description":"ICD-HIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5004","description":"Hospice in snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA1","description":"ICD-CICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF1","description":"ICD-NCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD0","description":"ICD-JIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC1","description":"ICD-MHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA0","description":"ICD-GCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE1","description":"ICD-DERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC0","description":"ICD-HCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA1","description":"ICD-CFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE0","description":"ICD-PJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","description":"CPT-00567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC0","description":"ICD-AAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1450","description":"Fluconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1200","description":"Diphenhydramine hcl injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF1","description":"ICD-BHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML01","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No rsk fac or 1 mod risk te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8970","description":"No rsk fac or 1 mod risk te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB1","description":"ICD-GBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA1","description":"ICD-BAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0930T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","description":"CPT-0930T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE1","description":"ICD-KFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB0","description":"ICD-KDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF0","description":"ICD-JBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facial moulage complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5912","description":"Facial moulage complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43135","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA0","description":"ICD-NDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temporary external pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92953","description":"Temporary external pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC1","description":"ICD-KEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA1","description":"ICD-MACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8567","description":"Pt no doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81419","description":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart image (pet) multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78492","description":"Heart image (pet) multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA1","description":"ICD-JFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pharynx foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42809","description":"Remove pharynx foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB1","description":"ICD-CDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB1","description":"ICD-JGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB0","description":"ICD-CAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF1","description":"ICD-DDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE1","description":"ICD-GBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial angioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61630","description":"Intracranial angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC1","description":"ICD-AEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exam/biopsy of vag w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57421","description":"Exam/biopsy of vag w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB1","description":"ICD-FHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA1","description":"ICD-DGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB240","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD1","description":"ICD-CBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2427","description":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture type immunofluoresc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87140","description":"Culture type immunofluoresc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2D","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA0","description":"ICD-BHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB1","description":"ICD-JFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate /3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1950","description":"Leuprolide acetate /3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA1","description":"ICD-CIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE0","description":"ICD-MADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF1","description":"ICD-CIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB0","description":"ICD-NEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD0","description":"ICD-EEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE0","description":"ICD-NFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB11","description":"ICD-4LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA1","description":"ICD-LCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE160","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB1","description":"ICD-FDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1354","description":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA1","description":"ICD-FGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2143","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Combo ankle/foot prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5975","description":"Combo ankle/foot prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61510","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD0","description":"ICD-BHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA0","description":"ICD-NKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0900T","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB0","description":"ICD-NEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD1","description":"ICD-NCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC0","description":"ICD-PLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy in eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5180","description":"Hh respiratory thrpy in eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE1","description":"ICD-CBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28435","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC260","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA1","description":"ICD-MGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1206","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB1","description":"ICD-CCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD0","description":"ICD-BGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC0","description":"ICD-KHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA1","description":"ICD-IGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","description":"CPT-15016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD1","description":"ICD-MJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB0","description":"ICD-BHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND1","description":"ICD-GAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC1","description":"ICD-AEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA0","description":"ICD-OLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA1","description":"ICD-JBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobility d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8980","description":"Mobility d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB0","description":"ICD-JEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spinal cord tract(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63170","description":"Incise spinal cord tract(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF1","description":"ICD-KBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA0","description":"ICD-GEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc limited","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9068","description":"Onc dx sclc/nsclc limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65410","description":"Biopsy of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA1","description":"ICD-KBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF0","description":"ICD-AGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF0","description":"ICD-OELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB1","description":"ICD-IHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suprv interfacilty transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99485","description":"Suprv interfacilty transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC0","description":"ICD-OJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF1","description":"ICD-FCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE0","description":"ICD-OBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD1","description":"ICD-MITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB144","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF0","description":"ICD-KEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57423","description":"Repair paravag defect lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB1","description":"ICD-KFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC0","description":"ICD-GALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15272","description":"Skin sub graft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surg on vag/urethral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94251","description":"Anesth surg on vag/urethral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE0","description":"ICD-OEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB0","description":"ICD-EITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF0","description":"ICD-CCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA0","description":"ICD-GBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sotalol hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9482","description":"Injection_ sotalol hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC0","description":"ICD-CEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB1","description":"ICD-HBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 2-3 vsts p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90952","description":"Esrd serv 2-3 vsts p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25370","description":"Revise radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA1","description":"ICD-MCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conductive garment for tens/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0731","description":"Conductive garment for tens/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opioid &opiate analog 5/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80364","description":"Opioid &opiate analog 5/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD0","description":"ICD-NFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2 shl symphys-stern cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0460","description":"Tlso 2 shl symphys-stern cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leads any type vad_ rep only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0487","description":"Leads any type vad_ rep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eyeglasses delux frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2025","description":"Eyeglasses delux frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC1","description":"ICD-CFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82105","description":"Alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electron elbow child switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7186","description":"Electron elbow child switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5C","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF0","description":"ICD-KIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental connector bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6920","description":"Dental connector bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD0","description":"ICD-IGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4B","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF0","description":"ICD-CDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC0","description":"ICD-NCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7171","description":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA1","description":"ICD-NFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA0","description":"ICD-KAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD1","description":"ICD-CHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47539","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33741","description":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA0","description":"ICD-GFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0624T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31786","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD0","description":"ICD-GHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD1","description":"ICD-IHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15946","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA31","description":"ICD-2LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of galactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82760","description":"Assay of galactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73706","description":"Ct angio lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC0","description":"ICD-PKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27605","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE1","description":"ICD-DEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthoptic/pleoptic training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92065","description":"Orthoptic/pleoptic training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc stent & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37231","description":"Tib/per revasc stent & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5741","description":"Denture reln part mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA1","description":"ICD-NCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF1","description":"ICD-LAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 12-25 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87633","description":"Resp virus 12-25 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0033","description":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9468","description":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg ordered rvwd reqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3650F","description":"Eeg ordered rvwd reqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB0","description":"ICD-OFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE0","description":"ICD-BGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44389","description":"Colonoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE1","description":"ICD-NKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF1","description":"ICD-DFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA0","description":"ICD-JHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD1","description":"ICD-JIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25130","description":"Removal of wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC0","description":"ICD-OEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay resin 3/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2652","description":"Dental inlay resin 3/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33130","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB0","description":"ICD-CFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF1","description":"ICD-MADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC1","description":"ICD-BFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy muscle graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15841","description":"Nerve palsy muscle graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee control full kneecap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2795","description":"Knee control full kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/2.25-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2112","description":"Spherocylindr 7.25d/2.25-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27178","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","description":"CPT-00730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL14","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD0","description":"ICD-CBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB0","description":"ICD-IHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC0","description":"ICD-PDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Activated carbon filter_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4680","description":"Activated carbon filter_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef special metabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4157","description":"Ef special metabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE1","description":"ICD-PBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate inf turbinate submuc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30802","description":"Ablate inf turbinate submuc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF1","description":"ICD-CDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calcium gluconate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0610","description":"Calcium gluconate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE0","description":"ICD-NCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prol intubation req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8569","description":"Prol intubation req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223T","description":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF1","description":"ICD-OIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE244","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continent stoma catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5082","description":"Continent stoma catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF0","description":"ICD-JBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL32","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement diaphragm/fplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7502","description":"Replacement diaphragm/fplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mesna injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9209","description":"Mesna injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78831","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB1","description":"ICD-ICBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA31","description":"ICD-1LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE0","description":"ICD-OHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB1","description":"ICD-GINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC0","description":"ICD-BIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA125","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1604","description":"HCPCS-C1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB1","description":"ICD-JCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6562","description":"Gradient compression stocking_ waist length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43123","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD0","description":"ICD-NCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE0","description":"ICD-OJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA0","description":"ICD-JGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA0","description":"ICD-KIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE1","description":"ICD-MICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"West nile virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86789","description":"West nile virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad w/backup non inv intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0471","description":"Rad w/backup non inv intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66170","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos clin depres scrn f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8431","description":"Pos clin depres scrn f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED0","description":"ICD-CIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49596","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB0","description":"ICD-ICEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1806","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1806","description":"CDT-D1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36585","description":"Replace picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maintenance 5% WL from baseline weight in months 7-12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9888","description":"Maintenance 5% WL from baseline weight in months 7-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF0","description":"ICD-MDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95060","description":"Eye allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81231","description":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25020","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Propranolol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1800","description":"Propranolol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9901","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5611","description":"repair resin partial denture base_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE0","description":"ICD-ACUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD0","description":"ICD-KIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME0","description":"ICD-CHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fecal blood scrn immunoassay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0328","description":"Fecal blood scrn immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon/muscle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26494","description":"Hand tendon/muscle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 2-4 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98961","description":"Self-mgmt educ/train 2-4 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB0","description":"ICD-GAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB1","description":"ICD-MEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE1","description":"ICD-GEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF1","description":"ICD-ECUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44361","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF1","description":"ICD-KFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF0","description":"ICD-EIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin test candida","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86485","description":"Skin test candida","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80333","description":"Antidepressants class 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mnpj of tmj w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21073","description":"Mnpj of tmj w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF0","description":"ICD-BIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF1","description":"ICD-CIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID0","description":"ICD-FAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2180","description":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB0","description":"ICD-DBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD1","description":"ICD-EHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem urinary collect dev cup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4327","description":"Fem urinary collect dev cup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tezepelumab-ekko_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2356","description":"Injection_ tezepelumab-ekko_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion other than face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15782","description":"Dermabrasion other than face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB1","description":"ICD-CGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vad different session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33992","description":"Remove vad different session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB0","description":"ICD-KERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36625","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD0","description":"ICD-CCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69661","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD0","description":"ICD-DFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC1","description":"ICD-JETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB1","description":"ICD-KEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body jawbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41806","description":"Removal foreign body jawbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66830","description":"Removal of lens lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC0","description":"ICD-JHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear and throat examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92502","description":"Ear and throat examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA124","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE0","description":"ICD-OAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC1","description":"ICD-BITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22206","description":"Incis spine 3 column thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","description":"CPT-15017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF0","description":"ICD-EHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID0","description":"ICD-GCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0712T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD1","description":"ICD-OBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4095F","description":"Pt not rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20605","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elb mold sock flex hinge pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6100","description":"Elb mold sock flex hinge pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB120","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE1","description":"ICD-GGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD121","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61692","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temporary tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4262","description":"Temporary tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB1","description":"ICD-PCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF1","description":"ICD-OEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB11","description":"ICD-4IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF1","description":"ICD-GHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13153","description":"Cmplx rpr e/n/e/l addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD1","description":"ICD-CDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC0","description":"ICD-ACAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD1","description":"ICD-FITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE1","description":"ICD-GBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC1","description":"ICD-NJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC31","description":"ICD-4FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB0","description":"ICD-KENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA0","description":"ICD-KEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0322","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE0","description":"ICD-FAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF0","description":"ICD-OBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55812","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD1","description":"ICD-BEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1221","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess dyspnea not present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1018F","description":"Assess dyspnea not present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL31","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC41","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF0","description":"ICD-OJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj ceftolozane tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0695","description":"Inj ceftolozane tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE236","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4C","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC125","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF1","description":"ICD-JCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB0","description":"ICD-AACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC1","description":"ICD-GBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF1","description":"ICD-HCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE1","description":"ICD-KFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi out nrm param nof/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8419","description":"Calc bmi out nrm param nof/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF0","description":"ICD-KBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8F","description":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92326","description":"Replacement of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC0","description":"ICD-GDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA1","description":"ICD-BITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD1","description":"ICD-BBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96380","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF0","description":"ICD-BDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC106","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ionm remote/>1 pt or per hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95941","description":"Ionm remote/>1 pt or per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21145","description":"Lefort i-1 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC1","description":"ICD-FHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF1","description":"ICD-ACDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65755","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tract frame attach headboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0840","description":"Tract frame attach headboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA225","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD1","description":"ICD-FABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA1","description":"ICD-CFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28002","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC1","description":"ICD-PKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detect agnt mult dna direc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87800","description":"Detect agnt mult dna direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97037","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64891","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB0","description":"ICD-PAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroidectomy_ total or complete with parathyroid autotransplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7555","description":"Thyroidectomy_ total or complete with parathyroid autotransplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE210","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE0","description":"ICD-GHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE225","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9190","description":"Medical reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB1","description":"ICD-NHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF1","description":"ICD-KEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC1","description":"ICD-CAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF1","description":"ICD-OARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA1","description":"ICD-MDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD1","description":"ICD-GEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA1","description":"ICD-CCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE1","description":"ICD-EHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC0","description":"ICD-FHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr w/o conv >4 sqi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4415","description":"Ost skn barr w/o conv >4 sqi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15920","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC0","description":"ICD-GAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD0","description":"ICD-BCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF1","description":"ICD-CEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26185","description":"Remove finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB0","description":"ICD-GCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC1","description":"ICD-ICIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Astigmatism-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2787","description":"Astigmatism-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA12","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA0","description":"ICD-CBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38220","description":"Diagnostic bone marrow; aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscop w/vc inj + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31571","description":"Laryngoscop w/vc inj + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87469","description":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther fostercare child /month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5146","description":"Ther fostercare child /month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE0","description":"ICD-OFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB0","description":"ICD-MJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9390","description":"No unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC1","description":"ICD-GAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level >9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3046F","description":"Hemoglobin a1c level >9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC0","description":"ICD-GAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply long arm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29105","description":"Apply long arm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE1","description":"ICD-FAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB1","description":"ICD-GHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1222","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA1","description":"ICD-MHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB1","description":"ICD-NIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD1","description":"ICD-KFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE0","description":"ICD-GGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF1","description":"ICD-GBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB0","description":"ICD-GIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray measurement of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74710","description":"X-ray measurement of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy fascial graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15840","description":"Nerve palsy fascial graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial thermo mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5580","description":"Prep ak ischial thermo mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB0","description":"ICD-JAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC1","description":"ICD-LEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE0","description":"ICD-OELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27727","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Veritas collagen matrix_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9354","description":"Veritas collagen matrix_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6604","description":"Cst bse mtl inlay 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0140U","description":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9021","description":"Red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35506","description":"Art byp grft subclav-carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD0","description":"ICD-CATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB0","description":"ICD-KHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD0","description":"ICD-EILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17271","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46761","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA240","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC0","description":"ICD-NCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB1","description":"ICD-FGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE1","description":"ICD-GEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID0","description":"ICD-OFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43206","description":"Esoph optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE116","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of palm tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26170","description":"Removal of palm tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88142","description":"Cytopath c/v thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4D","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF0","description":"ICD-IHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","description":"CPT-64474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54065","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Childbirth refresher class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9437","description":"Childbirth refresher class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND0","description":"ICD-KEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB1","description":"ICD-OLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0C","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD0","description":"ICD-FGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA0","description":"ICD-EDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA0","description":"ICD-CFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB0","description":"ICD-BICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA1","description":"ICD-NDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2154","description":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD1","description":"ICD-GDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1801","description":"HCPCS-A1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29835","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC0","description":"ICD-BDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50700","description":"Revision of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00910","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","description":"CPT-00910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21086","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA1","description":"ICD-GIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE0","description":"ICD-NAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF0","description":"ICD-KHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE0","description":"ICD-JCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA154","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF1","description":"ICD-ICEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF0","description":"ICD-KHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA0","description":"ICD-GDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB1","description":"ICD-OINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB0","description":"ICD-EGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD1","description":"ICD-GHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB0","description":"ICD-KCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD0","description":"ICD-JDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Miniature knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5826","description":"Miniature knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-thigh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6508","description":"Cmprs burngarment foot-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA1","description":"ICD-HEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27279","description":"Arthrodesis sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD0","description":"ICD-KALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57530","description":"Removal of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2198","description":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF1","description":"ICD-NLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq cardiac angio addl art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92921","description":"Prq cardiac angio addl art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB0","description":"ICD-MLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration replacmnt g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6915","description":"Hand restoration replacmnt g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44141","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic biometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92136","description":"Ophthalmic biometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA1","description":"ICD-KIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp screen mammogram add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77052","description":"Comp screen mammogram add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD246","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01852","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","description":"CPT-01852","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE1","description":"ICD-OBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous prp for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0460","description":"Autologous prp for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC21","description":"ICD-3JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC1","description":"ICD-HEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery ea add root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3426","description":"Root surgery ea add root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD0","description":"ICD-CEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2540","description":"Thigh/wght bear lacer molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND0","description":"ICD-CFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD0","description":"ICD-BFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md home visit outside cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0273","description":"Md home visit outside cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental retainr cast metl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6545","description":"Dental retainr cast metl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC1","description":"ICD-NCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB0","description":"ICD-KIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE1","description":"ICD-NFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Work hardening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97545","description":"Work hardening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC1","description":"ICD-PJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7533","description":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA0","description":"ICD-CEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC0","description":"ICD-PIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF0","description":"ICD-FIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE1","description":"ICD-MCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD1","description":"ICD-AEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36903","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise bile duct sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47460","description":"Incise bile duct sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB0","description":"ICD-NANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-2 no progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9090","description":"Onc dx rectal t1-2 no progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","description":"HCPCS-J2312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1553","description":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB1","description":"ICD-BCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE111","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8703","description":"Replacement Of Lost Or Broken Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prost cncr rsk not lw/md/hgh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3274F","description":"Prost cncr rsk not lw/md/hgh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB0","description":"ICD-GCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA0","description":"ICD-HHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC1","description":"ICD-GBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF0","description":"ICD-OIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0640T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB0","description":"ICD-OKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB1","description":"ICD-BINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC02","description":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Special Meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1764","description":"Home Delivered Meals-Special Meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (fsh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83001","description":"Assay of gonadotropin (fsh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE0","description":"ICD-BABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED1","description":"ICD-BHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33285","description":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-2a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9213","description":"Interferon alfa-2a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC0","description":"ICD-MDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Holotranscobalamin_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103T","description":"Holotranscobalamin_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB0","description":"ICD-NBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy remove segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32669","description":"Thoracoscopy remove segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD0","description":"ICD-LFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9315","description":"Doc first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82436","description":"Assay of urine chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88365","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","description":"HCPCS-J0614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52301","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE0","description":"ICD-NLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA0","description":"ICD-JENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8497","description":"Cabg meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35612","description":"Art byp subclav-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2+ anti-hyprtnsv agents tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4145F","description":"2+ anti-hyprtnsv agents tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126U","description":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot 22.05 & Motor <28.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); modulating antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86043","description":"Acetylcholine receptor (AChR); modulating antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81416","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9629","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8811","description":"No rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA0","description":"ICD-BFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC0","description":"ICD-JCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5C","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD1","description":"ICD-FIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC50","description":"Medium Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp iliorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35634","description":"Art byp iliorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC0","description":"ICD-BFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2390","description":"Solid drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA1","description":"ICD-JADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB217","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC1","description":"ICD-ABUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF1","description":"ICD-NDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA0","description":"ICD-GAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium ph inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1710","description":"Hydrocortisone sodium ph inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF1","description":"ICD-GEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15734","description":"Muscle-skin graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF1","description":"ICD-FHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar artif diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22857","description":"Lumbar artif diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF0","description":"ICD-CERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE0","description":"ICD-NCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1083T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1083T","description":"CPT-1083T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone 17-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83498","description":"Assay of progesterone 17-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC1","description":"ICD-CGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF0","description":"ICD-PFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE1","description":"ICD-PCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1076","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0183","description":"Prochlorperazine 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve remov addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31649","description":"Bronchial valve remov addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90677","description":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF1","description":"ICD-JHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE1","description":"ICD-IBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal over 12.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2214","description":"Lens sphcyl bifocal over 12.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2016","description":"Comp comm supp svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA1","description":"ICD-BBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF0","description":"ICD-ACDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB0","description":"ICD-BHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD1","description":"ICD-AGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo bk ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5940","description":"Endo bk ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD1","description":"ICD-PAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB1","description":"ICD-PCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX31","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA0","description":"ICD-KDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermapure 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4152","description":"Dermapure 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC0","description":"ICD-BGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0480U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","description":"CPT-0480U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC0","description":"ICD-NGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61550","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC1","description":"ICD-EHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD0","description":"ICD-BIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB0","description":"ICD-KDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB1","description":"ICD-AFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX32","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA1","description":"ICD-EBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2A","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27826","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB1","description":"ICD-IDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE1","description":"ICD-BAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62551","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9686","description":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD1","description":"ICD-NFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63741","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC1","description":"ICD-NAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF1","description":"ICD-KEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27665","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0567U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","description":"CPT-0567U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC1","description":"ICD-JILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86631","description":"Chlamydia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmptr ophth dx img ant segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92132","description":"Cmptr ophth dx img ant segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC1","description":"ICD-GDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB0","description":"ICD-CHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0978T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","description":"CPT-0978T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25315","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB0","description":"ICD-IBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA1","description":"ICD-ODEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB0","description":"ICD-OJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Level of activity assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1003F","description":"Level of activity assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00532","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","description":"CPT-00532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA0","description":"ICD-CEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA1","description":"ICD-OCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE0","description":"ICD-KAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB0","description":"ICD-FBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC0","description":"ICD-FATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Birthing class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9442","description":"Birthing class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8E","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental sealant per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1351","description":"Dental sealant per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8647","description":"Fun stat score knee >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA156","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC1","description":"ICD-MGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE0","description":"ICD-KEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA1","description":"ICD-GAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95712","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA1","description":"ICD-OEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC124","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21089","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg <=16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6212","description":"Foam drg <=16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME0","description":"ICD-OCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Malaria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86750","description":"Malaria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF1","description":"ICD-NEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0665","description":"Pneumatic appliance full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place endorectal app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9725","description":"Place endorectal app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD141","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD254","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46060","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB1","description":"ICD-JEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME1","description":"ICD-MGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD1","description":"ICD-GBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid >","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4178","description":"Parenteral sol amino acid >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9062","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9062","description":"HCPCS-J9062","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC1","description":"ICD-PIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE1","description":"ICD-BGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Truss add to std pad scrotal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8330","description":"Truss add to std pad scrotal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC1","description":"ICD-CDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC0","description":"ICD-JAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA0","description":"ICD-CHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-auto graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4285","description":"Non-auto graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL03","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delivery comp imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6016","description":"Delivery comp imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC246","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intercep dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8050","description":"Intercep dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB0","description":"ICD-FFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB0","description":"ICD-MDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE0","description":"ICD-HAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE1","description":"ICD-AADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE0","description":"ICD-GHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF1","description":"ICD-EIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF1","description":"ICD-FBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroid (t3 or t4)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84479","description":"Assay of thyroid (t3 or t4)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC0","description":"ICD-KCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE0","description":"ICD-KBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD1","description":"ICD-JEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF0","description":"ICD-FCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF0","description":"ICD-BDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Split blood or products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86985","description":"Split blood or products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gluco mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540F","description":"Gluco mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1402","description":"CDT-D1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB1","description":"ICD-CILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41899","description":"Dental surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"carePATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4236","description":"carePATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit sing/m/fam couns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99510","description":"Home visit sing/m/fam couns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD0","description":"ICD-BFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43831","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA0","description":"ICD-OABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA0","description":"ICD-MLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anemia plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516F","description":"Anemia plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47142","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC0","description":"ICD-BAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef assess planpost dschrge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3019F","description":"Lvef assess planpost dschrge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent assess vol mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8955","description":"Most recent assess vol mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF0","description":"ICD-OGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE0","description":"ICD-EADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2207","description":"Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky =50)_ cardiac c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE0","description":"ICD-HIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ socket bel elbow/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6687","description":"Frame typ socket bel elbow/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND1","description":"ICD-GDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0688T","description":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF1","description":"ICD-GEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE0","description":"ICD-CEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2372","description":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC0","description":"ICD-FAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comm psy face-face per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0036","description":"Comm psy face-face per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonprim loc anat bx site tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3250F","description":"Nonprim loc anat bx site tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Completed epsdt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0302","description":"Completed epsdt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB1","description":"ICD-AHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36584","description":"Replace picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE0","description":"ICD-OARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF1","description":"ICD-MCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD0","description":"ICD-MCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND0","description":"ICD-GDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect heart sac lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33050","description":"Resect heart sac lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC0","description":"ICD-OLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB0","description":"ICD-BINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & duct catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52010","description":"Cystoscopy & duct catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2109","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee joint drop lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2405","description":"Knee joint drop lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01953","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","description":"CPT-01953","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8E","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37284","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","description":"CPT-37284","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1305","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE1","description":"ICD-KCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore chest free adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32124","description":"Explore chest free adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Promoting wellness mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0005","description":"Promoting wellness mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9485","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF1","description":"ICD-GCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF0","description":"ICD-GERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB0","description":"ICD-ADTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab steel crown primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2934","description":"Prefab steel crown primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg press ventilation cnp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94662","description":"Neg press ventilation cnp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD0","description":"ICD-CDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE1","description":"ICD-AIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calaspargase pegol-mknl_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9118","description":"Injection_ calaspargase pegol-mknl_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for shoulder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23350","description":"Injection for shoulder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72129","description":"Ct chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2116","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE0","description":"ICD-MKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE0","description":"ICD-KBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lithotripsy_ coronary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1761","description":"Catheter_ transluminal intravascular lithotripsy_ coronary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF0","description":"ICD-BFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD1","description":"ICD-FFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ewho rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3763","description":"Ewho rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b surface antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86706","description":"Hep b surface antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB1","description":"ICD-OAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC0","description":"ICD-BBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE0","description":"ICD-KBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3A","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA0","description":"ICD-JGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride genit/per/abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11006","description":"Debride genit/per/abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD0","description":"ICD-FFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD0","description":"ICD-KEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF1","description":"ICD-NFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC1","description":"ICD-OIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC1","description":"ICD-NJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD1","description":"ICD-OFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Additional spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22585","description":"Additional spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2A","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA1","description":"ICD-CBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD1","description":"ICD-KHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND0","description":"ICD-GCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE0","description":"ICD-FGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF0","description":"ICD-MIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic salivary reflex s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0755","description":"Electronic salivary reflex s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49013","description":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 vst p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90959","description":"Esrd serv 1 vst p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81407","description":"Mopath procedure level 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA1","description":"ICD-KBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9697","description":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE1","description":"ICD-BIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE1","description":"ICD-EGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA1","description":"ICD-JAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I & d of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56405","description":"I & d of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE1","description":"ICD-OBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78469","description":"Heart infarct image (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE0","description":"ICD-LFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9029","description":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0324U","description":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE210","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD1","description":"ICD-CAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA1","description":"ICD-BHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC1","description":"ICD-OGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF1","description":"ICD-FHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219T","description":"Plmt post facet implt cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo tibial fracture rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2116","description":"Afo tibial fracture rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closd rductn splint alveolus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7670","description":"Closd rductn splint alveolus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adults currently taking pharmacotherapy for OUD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1032","description":"Adults currently taking pharmacotherapy for OUD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recd f/u w/in 30d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9402","description":"Recd f/u w/in 30d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA1","description":"ICD-NEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD0","description":"ICD-CIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90587","description":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB0","description":"ICD-JDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA1","description":"ICD-JIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE0","description":"ICD-NEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB0","description":"ICD-FBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD0","description":"ICD-NKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph bx rprt w/dyspl info","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3126F","description":"Esoph bx rprt w/dyspl info","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0510","description":"Non-prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA1","description":"ICD-KBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24075","description":"Exc arm/elbow les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD216","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt shldr dis/interc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6885","description":"Replc sockt shldr dis/interc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1072","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","description":"HCPCS-J1072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC31","description":"ICD-4BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc no daily aspirin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9278","description":"Doc no daily aspirin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & remove clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61154","description":"Pierce skull & remove clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA0","description":"ICD-CEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC0","description":"ICD-ACMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF0","description":"ICD-CCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB0","description":"ICD-MHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD0","description":"ICD-AGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE0","description":"ICD-DGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB1","description":"ICD-FCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD0","description":"ICD-NDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27443","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12014","description":"Rpr f/e/e/n/l/m 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87552","description":"Mycobacteria dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB0","description":"ICD-FHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86663","description":"Epstein-barr antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC0","description":"ICD-FDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF0","description":"ICD-CGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF0","description":"ICD-BFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr guidance for needle place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77021","description":"Mr guidance for needle place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE0","description":"ICD-GFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90759","description":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB0","description":"ICD-MBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF1","description":"ICD-EBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC1","description":"ICD-JGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE0","description":"ICD-GCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF0","description":"ICD-OGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Degarelix injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9155","description":"Degarelix injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9718","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA0","description":"ICD-MKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4019","description":"Cast sup lng arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA0","description":"ICD-OCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE0","description":"ICD-KCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58350","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6518","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","description":"HCPCS-A6518","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA1","description":"ICD-FCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD0","description":"ICD-NBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF1","description":"ICD-OJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF1","description":"ICD-MEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC0","description":"ICD-EGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC1","description":"ICD-JCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA24","description":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost urine pch w b/bltin conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4430","description":"Ost urine pch w b/bltin conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iop down <15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3285F","description":"Iop down <15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6122","description":"Implant Supported Retainer For Metal Fpd - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC0","description":"ICD-CIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF0","description":"ICD-GHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA1","description":"ICD-JBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for heart biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76932","description":"Echo guide for heart biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37292","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","description":"CPT-37292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1335","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA0","description":"ICD-NKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA0","description":"ICD-IADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1834","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","description":"HCPCS-J1834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB1","description":"ICD-GCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE0","description":"ICD-ADUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23655","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA11","description":"ICD-4FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA0","description":"ICD-OBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND0","description":"ICD-NBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65850","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77439","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","description":"CPT-77439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB1","description":"ICD-GFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB0","description":"ICD-OLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vit d 1 25-dihydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82652","description":"Vit d 1 25-dihydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB1","description":"ICD-BGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA1","description":"ICD-NIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","description":"HCPCS-G0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD0","description":"ICD-FHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB244","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28476","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43020","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0990T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","description":"CPT-0990T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0090","description":"Interest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest stem cell concentrte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38215","description":"Harvest stem cell concentrte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","description":"HCPCS-G0183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE1","description":"ICD-FEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelet deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38213","description":"Platelet deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD0","description":"ICD-NAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB1","description":"ICD-OKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine screen for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81007","description":"Urine screen for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF0","description":"ICD-CAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC0","description":"ICD-DEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC1","description":"ICD-BFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate clinical met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9133","description":"Onc dx prostate clinical met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA0","description":"ICD-DFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD1","description":"ICD-JGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1056","description":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vim_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4251","description":"Vim_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND1","description":"ICD-JCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0987T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","description":"CPT-0987T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB1","description":"ICD-OISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE0","description":"ICD-IIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC0","description":"ICD-LHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artacent AC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4189","description":"Artacent AC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scrn hcv infec not recd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9386","description":"Scrn hcv infec not recd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60220","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC0","description":"ICD-OHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD0","description":"ICD-ODBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9755","description":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF1","description":"ICD-BEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB1","description":"ICD-NBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF1","description":"ICD-LGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC0","description":"ICD-CHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF1","description":"ICD-AIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD1","description":"ICD-OGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t2no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9078","description":"Onc dx prostate t2no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA0","description":"ICD-NFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB115","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB1","description":"ICD-KAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB1","description":"ICD-MDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB0","description":"ICD-KIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA0","description":"ICD-CATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina tissue part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57107","description":"Remove vagina tissue part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD0","description":"ICD-KIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB0","description":"ICD-JECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB1","description":"ICD-JBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD1","description":"ICD-OGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93532","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65114","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB0","description":"ICD-GGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME0","description":"ICD-MDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"JR GNOTYP ABCG2 EXONS 2-26","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0193U","description":"JR GNOTYP ABCG2 EXONS 2-26","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9218","description":"Leuprolide acetate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Oritavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9444","description":"Injection_ Oritavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0014","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB21","description":"ICD-1KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bile acids total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82239","description":"Bile acids total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70487","description":"Ct maxillofacial w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF1","description":"ICD-MLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF0","description":"ICD-AEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00873","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","description":"CPT-00873","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE1","description":"ICD-DHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD0","description":"ICD-AAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE1","description":"ICD-PISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD1","description":"ICD-BEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE1","description":"ICD-CGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC0","description":"ICD-GFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21154","description":"Lefort iii w/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE0","description":"ICD-OCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC06","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93615","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD0","description":"ICD-JEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urgent Care Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4036","description":"Urgent Care Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0636U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0636U","description":"CPT-0636U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA1","description":"ICD-KGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA0","description":"ICD-MEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE0","description":"ICD-MLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE0","description":"ICD-ABUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB1","description":"ICD-CHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA1","description":"ICD-BAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE0","description":"ICD-LHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rabies ig im/sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90375","description":"Rabies ig im/sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB0","description":"ICD-BBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA150","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC0","description":"ICD-BFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9005","description":"Mccd_ risk adj_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94014","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD1","description":"ICD-GDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE0","description":"ICD-JDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2205","description":"Lens sphcy bifocal 4.00d/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD1","description":"ICD-ADAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stance phase only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5858","description":"Stance phase only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Consultation with a medical health care professional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9311","description":"Consultation with a medical health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intra-arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79445","description":"Nuclear rx intra-arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF0","description":"ICD-OEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD0","description":"ICD-EDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE0","description":"ICD-CCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore and drain kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50125","description":"Explore and drain kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","description":"CPT-00520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic anrysm5.5-5.9cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9003F","description":"Aortic anrysm5.5-5.9cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC1","description":"ICD-NGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reusable pull-on any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4536","description":"Reusable pull-on any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC1","description":"ICD-BHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE0","description":"ICD-OATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF0","description":"ICD-OLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27364","description":"Resect thigh/knee tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC0","description":"ICD-CEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 1 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34841","description":"Endovasc visc aorta 1 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB0","description":"ICD-KBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9904","description":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF0","description":"ICD-JINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ brexanolone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1632","description":"Injection_ brexanolone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6024","description":"Collagen dsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC1","description":"ICD-OKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC1","description":"ICD-AFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB126","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rep part denture cast frame","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5620","description":"Rep part denture cast frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC0","description":"ICD-CHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC1","description":"ICD-LIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC145","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver whole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47143","description":"Prep donor liver whole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA1","description":"ICD-HFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC0","description":"ICD-CFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC1","description":"ICD-AABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harness figure of 8 dual con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6676","description":"Harness figure of 8 dual con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB0","description":"ICD-MEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE1","description":"ICD-HGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC1","description":"ICD-CDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD1","description":"ICD-CGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA1","description":"ICD-EEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB0","description":"ICD-GDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35693","description":"Art trnsposj subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TAG_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4261","description":"TAG_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME0","description":"ICD-OGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC1","description":"ICD-OLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA1","description":"ICD-KECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0948T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","description":"CPT-0948T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE1","description":"ICD-ODSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55874","description":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC0","description":"ICD-PBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC0","description":"ICD-OELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD0","description":"ICD-PFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF1","description":"ICD-GGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81259","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81233","description":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32900","description":"Removal of rib(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1205","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Matristem burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4120","description":"Matristem burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76978","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42971","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortbifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35540","description":"Art byp grft aortbifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70328","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC1","description":"ICD-LCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50600","description":"Exploration of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE1","description":"ICD-FFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF0","description":"ICD-OJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv <10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4193F","description":"Pt rcv <10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD1","description":"ICD-GHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA0","description":"ICD-OJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE0","description":"ICD-KETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA1","description":"ICD-IDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20200","description":"Muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA0","description":"ICD-ECEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2b hr_nopro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9071","description":"Onc dx brst stg1-2b hr_nopro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC0","description":"ICD-FHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE1","description":"ICD-PBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0187","description":"Water pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF0","description":"ICD-MEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45315","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","description":"HCPCS-M1374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87537","description":"Hiv-2 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9048","description":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA0","description":"ICD-BHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB1","description":"ICD-CEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC1","description":"ICD-OIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA0","description":"ICD-FBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22251","description":"Anesth head nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA1","description":"ICD-CDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC215","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF0","description":"ICD-OCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA0","description":"ICD-OLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB0","description":"ICD-CIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB0","description":"ICD-BBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Work related disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99455","description":"Work related disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE0","description":"ICD-NANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB1","description":"ICD-KDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF1","description":"ICD-OAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20934","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD0","description":"ICD-KILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB0","description":"ICD-PDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE131","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75805","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81204","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD1","description":"ICD-NEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF1","description":"ICD-JFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA1","description":"ICD-GGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC1","description":"ICD-NEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flurazepam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6051","description":"Flurazepam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc repair abdom aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75952","description":"Endovasc repair abdom aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82482","description":"Assay rbc cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC0","description":"ICD-JBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35206","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9681","description":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA1","description":"ICD-CAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC1","description":"ICD-GETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA0","description":"ICD-JEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA1","description":"ICD-EDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2B","description":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA0","description":"ICD-OKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cadmium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82300","description":"Assay of cadmium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone srgry cmptr fluor image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054T","description":"Bone srgry cmptr fluor image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD0","description":"ICD-KBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF1","description":"ICD-GDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82486","description":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intra-atrial recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93602","description":"Intra-atrial recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55000","description":"Drainage of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB0","description":"ICD-HCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC1","description":"ICD-BBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC0","description":"ICD-BDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34451","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure ureter/skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50920","description":"Closure ureter/skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC1","description":"ICD-MIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1208","description":"Number of patients not screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47800","description":"Reconstruction of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molded socket shin sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5100","description":"Molded socket shin sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF0","description":"ICD-OEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4542","description":"Small disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64493","description":"Inj paravert f jnt l/s 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig footwear evaluatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8416","description":"Pt inelig footwear evaluatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduce bowel obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44050","description":"Reduce bowel obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF1","description":"ICD-KAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC1","description":"ICD-CAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE0","description":"ICD-NEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna dir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87797","description":"Detect agent nos dna dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0279","description":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0504","description":"HCPCS-B0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA1","description":"ICD-OGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF0","description":"ICD-PBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD0","description":"ICD-FHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB0","description":"ICD-PAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA0","description":"ICD-KBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB1","description":"ICD-BCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply srs headframe add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61800","description":"Apply srs headframe add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33391","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA1","description":"ICD-JGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB1","description":"ICD-IBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Distal shoe space maintainer - fixed - unilateral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1575","description":"Distal shoe space maintainer - fixed - unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC1","description":"ICD-GIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5108","description":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retain crown resin w hi nble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6720","description":"Retain crown resin w hi nble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF1","description":"ICD-MFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1430","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","description":"HCPCS-M1430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eyelid abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67700","description":"Drainage of eyelid abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA0","description":"ICD-CFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB1","description":"ICD-IFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF0","description":"ICD-JCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7189","description":"Factor viia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2395","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74019","description":"Radiologic examination_ abdomen; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8B","description":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat vaginal bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57180","description":"Treat vaginal bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD1","description":"ICD-GCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD1","description":"ICD-FIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA42","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA0","description":"ICD-MHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX05","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92310","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC1","description":"ICD-NKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC0","description":"ICD-KARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD1","description":"ICD-CEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv flex n/adj foam pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0120","description":"Cerv flex n/adj foam pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF1","description":"ICD-BAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE0","description":"ICD-NCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC1","description":"ICD-OGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9450","description":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA1","description":"ICD-FACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98977","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE1","description":"ICD-MADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36253","description":"Ins cath ren art 2nd+ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA0","description":"ICD-HFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC0","description":"ICD-OHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB112","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE1","description":"ICD-OCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299U","description":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pdgfra gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81314","description":"Pdgfra gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA0","description":"ICD-BDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX50","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF0","description":"ICD-FFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA0","description":"ICD-KALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD211","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13102","description":"Cmplx rpr trunk addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic incision larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31320","description":"Diagnostic incision larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB0","description":"ICD-JFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6028","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE0","description":"ICD-DCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA1","description":"ICD-NKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF0","description":"ICD-OIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81351","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lat thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22532","description":"Lat thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0584U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","description":"CPT-0584U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF1","description":"ICD-NDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hx injec drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9450","description":"Hx injec drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA0","description":"ICD-KFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurgery anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46916","description":"Cryosurgery anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB1","description":"ICD-JIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB1","description":"ICD-OJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient spent greater than or equal to three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9861","description":"Patient spent greater than or equal to three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","description":"HCPCS-J0139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA0","description":"ICD-KCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flecainide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80181","description":"Flecainide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bp sys <140 and dias <90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8476","description":"Bp sys <140 and dias <90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doripenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1267","description":"Doripenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD0","description":"ICD-IBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alloderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4116","description":"Alloderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC0","description":"ICD-KAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB155","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD0","description":"ICD-GHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD1","description":"ICD-PLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detect agnt mult dna ampli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87801","description":"Detect agnt mult dna ampli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC0","description":"ICD-LDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF1","description":"ICD-MIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA0","description":"ICD-NGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay everolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80169","description":"Drug assay everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m depreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9536","description":"Tc99m depreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9767","description":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA1","description":"ICD-MBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acesso AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4312","description":"Acesso AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA0","description":"ICD-JGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10007","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15131","description":"Derm autograft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX01","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs spinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63620","description":"Srs spinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB1","description":"ICD-MHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF0","description":"ICD-OBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9362","description":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disease management program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0315","description":"Disease management program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB1","description":"ICD-GHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC0","description":"ICD-GADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA0","description":"ICD-IDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid check one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92592","description":"Hearing aid check one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37244","description":"Vasc embolize/occlude bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC0","description":"ICD-CIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0D","description":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA1","description":"ICD-NFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurorraphy w/vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64911","description":"Neurorraphy w/vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE0","description":"ICD-GCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD0","description":"ICD-CEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC1","description":"ICD-DAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA155","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE1","description":"ICD-HCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0B","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC1","description":"ICD-GHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA1","description":"ICD-NGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE1","description":"ICD-LAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c genotype prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9207","description":"Hep c genotype prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB1","description":"ICD-JGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0843","description":"Pwc gp2 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of corticosteroids 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83491","description":"Assay of corticosteroids 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF1","description":"ICD-BIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA1","description":"ICD-LBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell count >= 500 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3496F","description":"Cd4+ cell count >= 500 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC1","description":"ICD-EIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA1","description":"ICD-OEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB1","description":"ICD-JILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA1","description":"ICD-AFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE0","description":"ICD-KIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE1","description":"ICD-LAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED1","description":"ICD-MCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE1","description":"ICD-IFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA0","description":"ICD-GHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD0","description":"ICD-OBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB0","description":"ICD-ODBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA0","description":"ICD-LISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Single transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26553","description":"Single transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX50","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB1","description":"ICD-AETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA1","description":"ICD-JBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC1","description":"ICD-PFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restorigin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4191","description":"Restorigin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA1","description":"ICD-FIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26548","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43341","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC1","description":"ICD-GFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gdh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82965","description":"Assay of gdh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colostomy with biopsies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44322","description":"Colostomy with biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF0","description":"ICD-JBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE105","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF0","description":"ICD-EICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0373","description":"intraoral tomosynthesis - bitewing radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD1","description":"ICD-AHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC05","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE1","description":"ICD-BACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC1","description":"ICD-GFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE1","description":"ICD-OKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA1","description":"ICD-MLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0493","description":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9695","description":"Long-acting inhaled bronchodilator prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE1","description":"ICD-LDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE0","description":"ICD-FILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE145","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE126","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE1","description":"ICD-JGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3D","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA1","description":"ICD-CBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam for fungi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87220","description":"Tissue exam for fungi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF0","description":"ICD-JEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD1","description":"ICD-CESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC1","description":"ICD-NAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA0","description":"ICD-KCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upr/l xtremity art 2 levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93922","description":"Upr/l xtremity art 2 levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpt pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9428","description":"Rpt pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE0","description":"ICD-FIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD0","description":"ICD-OKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD1","description":"ICD-DBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF1","description":"ICD-LGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54230","description":"Prepare penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8618","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ hla-m_ l/r_ unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9052","description":"Platelets_ hla-m_ l/r_ unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA1","description":"ICD-CEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC0","description":"ICD-MKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA0","description":"ICD-BHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE0","description":"ICD-OCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB1","description":"ICD-OGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC0","description":"ICD-KFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3346","description":"Retreat root canal anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC234","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE1","description":"ICD-JHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF0","description":"ICD-DGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55842","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF0","description":"ICD-FFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External beam to prost only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4200F","description":"External beam to prost only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Helminth antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86682","description":"Helminth antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8X","description":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8922","description":"Tte w or w/o fol w/cont_ f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA154","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1014T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","description":"CPT-1014T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD1","description":"ICD-EFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD1","description":"ICD-CCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Singl prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0504","description":"Singl prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81185","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD0","description":"ICD-JAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-expandable controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2375","description":"Non-expandable controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE0","description":"ICD-HESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF1","description":"ICD-OIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bile acids cholylglycine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82240","description":"Bile acids cholylglycine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA221","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0106","description":"HCPCS-A0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE1","description":"ICD-GBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE1","description":"ICD-KDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB131","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD1","description":"ICD-EFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC0","description":"ICD-OKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61615","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj filgrastim excl biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1442","description":"Inj filgrastim excl biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","description":"CPT-00924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7210","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD1","description":"ICD-CHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD0","description":"ICD-BBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD1","description":"ICD-KDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift sling or seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0621","description":"Patient lift sling or seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0667U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0667U","description":"CPT-0667U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vit for macular hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67042","description":"Vit for macular hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND1","description":"ICD-OLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stenger test pure tone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92565","description":"Stenger test pure tone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD0","description":"ICD-ICCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB0","description":"ICD-ABIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC0","description":"ICD-GBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE1","description":"ICD-JDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intra-atrial pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93610","description":"Intra-atrial pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9775","description":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE1","description":"ICD-KFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splint elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8452","description":"Splint elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB11","description":"ICD-3AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA1","description":"ICD-OJYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA0","description":"ICD-FEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ drainage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1729","description":"Cath_ drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD1","description":"ICD-CBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA1","description":"ICD-JAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB1","description":"ICD-FFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16020","description":"Dress/debrid p-thick burn s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA1","description":"ICD-NJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB0","description":"ICD-BDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27503","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mcoln1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81290","description":"Mcoln1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA0","description":"ICD-GHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC1","description":"ICD-CEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36561","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC0","description":"ICD-CAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiokymography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0035","description":"Cardiokymography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418U","description":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB0","description":"ICD-GAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ganciclovir sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1570","description":"Ganciclovir sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE1","description":"ICD-CHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC0","description":"ICD-IGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interface_ cough stim device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7020","description":"Interface_ cough stim device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF1","description":"ICD-KHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB0","description":"ICD-NLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cbc/diffwbc w/o platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0306","description":"Cbc/diffwbc w/o platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pin finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26756","description":"Pin finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bile tract surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47999","description":"Bile tract surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61151","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX43","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0D","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB0","description":"ICD-NAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA1","description":"ICD-KBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl ambient or axolotl cryo_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4215","description":"Axolotl ambient or axolotl cryo_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE1","description":"ICD-OBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43502","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fresnell prism press-on lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2718","description":"Fresnell prism press-on lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7198","description":"Anti-inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0849","description":"Pwc gp 3 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA0","description":"ICD-OCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Goserelin acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9202","description":"Goserelin acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE1","description":"ICD-NBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC1","description":"ICD-CFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF1","description":"ICD-GAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB1","description":"ICD-FBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB26","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA0","description":"ICD-NBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90837","description":"Psytx pt&/family 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1602","description":"HCPCS-C1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual pump enema_ reusable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4459","description":"Manual pump enema_ reusable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB1","description":"ICD-OKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc stom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43659","description":"Laparoscope proc stom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81176","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB0","description":"ICD-OHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF1","description":"ICD-KHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA31","description":"ICD-2KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC1","description":"ICD-LERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB1","description":"ICD-JFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA0","description":"ICD-NFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid &","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4189","description":"Parenteral sol amino acid &","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC1","description":"ICD-MDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0603","description":"HCPCS-C0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate inf turbinate superf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30801","description":"Ablate inf turbinate superf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ra tracer id of sentinl node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38792","description":"Ra tracer id of sentinl node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX34","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA0","description":"ICD-NLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE0","description":"ICD-BIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk waist belt webbing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5688","description":"Bk waist belt webbing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA1","description":"ICD-HCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE0","description":"ICD-BHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for percutaneous transhepatic cholangiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47500","description":"Injection procedure for percutaneous transhepatic cholangiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC0","description":"ICD-EEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61055","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resin infiltration of lesion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2990","description":"Resin infiltration of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC1","description":"ICD-OKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF0","description":"ICD-CDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE1","description":"ICD-GAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0247","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99355","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF1","description":"ICD-MEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC1","description":"ICD-IETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB1","description":"ICD-KHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD1","description":"ICD-PFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE0","description":"ICD-IHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0149","description":"Heavy duty wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE0","description":"ICD-CFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA0","description":"ICD-JBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelvis w/o contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74176","description":"Ct abd & pelvis w/o contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD0","description":"ICD-AATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA0","description":"ICD-NCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE1","description":"ICD-EAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF1","description":"ICD-BBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB1","description":"ICD-OBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB46","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9487","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA1","description":"ICD-KAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE1","description":"ICD-KHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC1","description":"ICD-GDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9310","description":"Injection_ rituximab_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pyruvate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84210","description":"Assay of pyruvate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA0","description":"ICD-NGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3C","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin i enzyme test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82164","description":"Angiotensin i enzyme test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC204","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac event recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0616","description":"Cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA1","description":"ICD-PCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA0","description":"ICD-AHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of arm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23930","description":"Drainage of arm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24655","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE1","description":"ICD-JFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB21","description":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA1","description":"ICD-NDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF0","description":"ICD-GEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neostim dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4267","description":"Neostim dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA0","description":"ICD-FHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC0","description":"ICD-FAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD1","description":"ICD-JAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ertapenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1335","description":"Ertapenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB41","description":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mohs 1 stage h/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17311","description":"Mohs 1 stage h/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB101","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluid flow or fluid GF_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4206","description":"Fluid flow or fluid GF_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4014","description":"Cast sup gauntlet fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5877","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5877","description":"CDT-D5877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext breastprosthesis garment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8015","description":"Ext breastprosthesis garment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55881","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","description":"CPT-55881","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA0","description":"ICD-CCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA1","description":"ICD-FFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC0","description":"ICD-CHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA0","description":"ICD-EATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject/aspirate liver cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47015","description":"Inject/aspirate liver cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE1","description":"ICD-ODLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0829","description":"Pwc gp 2 xtra hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA1","description":"ICD-GCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF0","description":"ICD-LFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF0","description":"ICD-NCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED0","description":"ICD-ADED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA0","description":"ICD-KGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0715T","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recd f/u w/in 7d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9405","description":"Recd f/u w/in 7d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"School-based iep ser bundled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1018","description":"School-based iep ser bundled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical traction therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97012","description":"Mechanical traction therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest compression gen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0483","description":"Chest compression gen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7321","description":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB0","description":"ICD-CFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul perm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283T","description":"Periph field stimul perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB1","description":"ICD-OKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA1","description":"ICD-FBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8H","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC1","description":"ICD-AAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE1","description":"ICD-MBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC1","description":"ICD-MFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB1","description":"ICD-IDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/comput","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88361","description":"Tumor immunohistochem/comput","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip disartic sach thermopls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5595","description":"Hip disartic sach thermopls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9683","description":"Onsite Ac Tx Nsg Fac Res Fl/Elct Do/Deh Bill Sid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF0","description":"ICD-IGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC1","description":"ICD-KEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0503","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mattress foam rubber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0272","description":"Mattress foam rubber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD0","description":"ICD-PGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23073","description":"Exc shoulder tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52315","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC0","description":"ICD-PLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE0","description":"ICD-GBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photodynmc tx 30 min add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96570","description":"Photodynmc tx 30 min add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA1","description":"ICD-NIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vc lesion scope/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31546","description":"Remove vc lesion scope/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC1","description":"ICD-KDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amitriptyline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1320","description":"Amitriptyline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE0","description":"ICD-ECAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB134","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD145","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68815","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD0","description":"ICD-PIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26075","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB0","description":"ICD-PKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA0","description":"ICD-BATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cortisol free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82530","description":"Cortisol free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF0","description":"ICD-BEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp stent exchange w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43276","description":"Ercp stent exchange w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped hospital bed_ manual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0328","description":"Ped hospital bed_ manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visit to determ ldct elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0296","description":"Visit to determ ldct elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB117","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE0","description":"ICD-PCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44144","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis addl spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22216","description":"Incis addl spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1024","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC0","description":"ICD-NJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB1","description":"ICD-KFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27497","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD0","description":"ICD-KEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC21","description":"ICD-2EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA1","description":"ICD-GEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7179","description":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE1","description":"ICD-NHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin fungi culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87101","description":"Skin fungi culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87525","description":"Hepatitis g dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metallic 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2543","description":"Dental onlay metallic 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD1","description":"ICD-CGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA0","description":"ICD-HAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dacarbazine 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9130","description":"Dacarbazine 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv saliv glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64611","description":"Chemodenerv saliv glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43840","description":"Repair of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB0","description":"ICD-BELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD0","description":"ICD-LDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Homemaker service nos /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5131","description":"Homemaker service nos /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinusoidal rotational test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92546","description":"Sinusoidal rotational test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11422","description":"Exc h-f-nk-sp b9+marg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD0","description":"ICD-CAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier_ wipe or swab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5120","description":"Skin barrier_ wipe or swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD0","description":"ICD-ECMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF0","description":"ICD-CGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko supracondylar socket mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1860","description":"Ko supracondylar socket mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD0","description":"ICD-BBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA0","description":"ICD-NFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD0","description":"ICD-DGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97154","description":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC0","description":"ICD-MBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9908","description":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB21","description":"ICD-3HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA1","description":"ICD-PIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB0","description":"ICD-KAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE0","description":"ICD-BALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42335","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB1","description":"ICD-BEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD0","description":"ICD-GHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE1","description":"ICD-EFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF1","description":"ICD-ADTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF0","description":"ICD-EDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE1","description":"ICD-IECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB1","description":"ICD-OELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev soft tiss add imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10036","description":"Perq dev soft tiss add imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1001","description":"Antepartum management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64893","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB0","description":"ICD-EDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr smpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77385","description":"Ntsty modul rad tx dlvr smpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF1","description":"ICD-NLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF1","description":"ICD-BGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4000","description":"Dermatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID1","description":"ICD-EIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE0","description":"ICD-MDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF1","description":"ICD-HEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt implant pros dev_no cov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9899","description":"Inpt implant pros dev_no cov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL32","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam <7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92601","description":"Cochlear implt f/up exam <7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray kidneys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75833","description":"Vein x-ray kidneys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95955","description":"Eeg during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD214","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE1","description":"ICD-JFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC0","description":"ICD-BEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD0","description":"ICD-OLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF1","description":"ICD-JFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF1","description":"ICD-KACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA1","description":"ICD-NBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA1","description":"ICD-CELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthe <60 min as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4256F","description":"Anesthe <60 min as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD1","description":"ICD-PAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE1","description":"ICD-MBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC0","description":"ICD-HISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC1","description":"ICD-FFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD0","description":"ICD-OAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01744","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","description":"CPT-01744","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF1","description":"ICD-CAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD0","description":"ICD-AADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB0","description":"ICD-OEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB0","description":"ICD-OLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reusable enema bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4458","description":"Reusable enema bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD213","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL51","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA0","description":"ICD-KAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family psytx w/o patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90846","description":"Family psytx w/o patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supported employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2024","description":"Supported employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF0","description":"ICD-ICAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC1","description":"ICD-HEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA1","description":"ICD-JAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0881T","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE1","description":"ICD-CAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay lipoprotein pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83698","description":"Assay lipoprotein pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB205","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES251","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lodging costs (e.g. hotel ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9994","description":"Lodging costs (e.g. hotel ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27750","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE1","description":"ICD-NDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD0","description":"ICD-BIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE1","description":"ICD-GIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC0","description":"ICD-BHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC244","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17282","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33460","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flexion/extension wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6620","description":"Flexion/extension wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2920","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC0","description":"ICD-FDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF1","description":"ICD-OEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420U","description":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibula bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20955","description":"Fibula bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE1","description":"ICD-NIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Voice d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9173","description":"Voice d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA0","description":"ICD-GDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310U","description":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9066","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9066","description":"HCPCS-J9066","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk fork strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5684","description":"Bk fork strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC1","description":"ICD-LDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB1","description":"ICD-NBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415U","description":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1004T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","description":"CPT-1004T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD0","description":"ICD-OHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no scrn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9452","description":"Doc med reas no scrn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA0","description":"ICD-MHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF0","description":"ICD-PBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD0","description":"ICD-BDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF0","description":"ICD-ACTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD0","description":"ICD-FHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF1","description":"ICD-KGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/t/o & vag repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58263","description":"Vag hyst w/t/o & vag repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE0","description":"ICD-JFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41112","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0633T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE0","description":"ICD-FGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC0","description":"ICD-GFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB1","description":"ICD-MFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF0","description":"ICD-JIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0556U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","description":"CPT-0556U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qual life tool 2x same/impr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9634","description":"Qual life tool 2x same/impr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gammaplex injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1557","description":"Gammaplex injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA0","description":"ICD-FGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE1","description":"ICD-GAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cutaquig)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1551","description":"Injection_ immune globulin (Cutaquig)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB0","description":"ICD-EBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patten bottom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2370","description":"Patten bottom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF1","description":"ICD-DARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF1","description":"ICD-NBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatogram assay sugars","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84375","description":"Chromatogram assay sugars","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast adjuvant chemotherapy administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9829","description":"Breast adjuvant chemotherapy administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA0","description":"ICD-KEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA1","description":"ICD-BHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2C","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA22","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD1","description":"ICD-FHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB1","description":"ICD-GAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD1","description":"ICD-KCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF1","description":"ICD-NFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA1","description":"ICD-CHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25335","description":"Realignment of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0593","description":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant gabapentin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80171","description":"Drug screen quant gabapentin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shock absorber for man w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1015","description":"Shock absorber for man w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27740","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28232","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE244","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB0","description":"ICD-KGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA0","description":"ICD-OHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE0","description":"ICD-JIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB0","description":"ICD-IILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE1","description":"ICD-NDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE0","description":"ICD-FEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF0","description":"ICD-KFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE0","description":"ICD-KBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE1","description":"ICD-CFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0302","description":"HCPCS-B0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF0","description":"ICD-NEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD1","description":"ICD-DCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID1","description":"ICD-NCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 7-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4176","description":"Parenteral sol amino acid 7-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","description":"HCPCS-J7172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC1","description":"ICD-BDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are receiving comfort care only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9930","description":"Patients who are receiving comfort care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC1","description":"ICD-BBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD1","description":"ICD-CGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND0","description":"ICD-BAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0134","description":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE0","description":"ICD-LAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14020","description":"Tis trnfr s/a/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB1","description":"ICD-IEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF1","description":"ICD-AGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB0","description":"ICD-LISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA0","description":"ICD-NBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Filleted finger/toe flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14350","description":"Filleted finger/toe flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB1","description":"ICD-KAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX31","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE0","description":"ICD-MFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87480","description":"Candida dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD0","description":"ICD-KGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm cmplt maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5810","description":"Denture interm cmplt maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF0","description":"ICD-BGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90656","description":"Iiv3 vacc no prsv 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab 10 mg and hyaluronidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9311","description":"Injection_ rituximab 10 mg and hyaluronidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME0","description":"ICD-CCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7324","description":"Orthovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9927","description":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Igg 1 2 3 or 4 each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82787","description":"Igg 1 2 3 or 4 each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral place of fix dev","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7998","description":"Intraoral place of fix dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD0","description":"ICD-BBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iv chelationtherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0300","description":"Iv chelationtherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE1","description":"ICD-KEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC0","description":"ICD-KFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE1","description":"ICD-FBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF0","description":"ICD-NBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC50","description":"Very High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME1","description":"ICD-JHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev modifier wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6805","description":"Term dev modifier wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF1","description":"ICD-GGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7168","description":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD1","description":"ICD-BFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE1","description":"ICD-MDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA1","description":"ICD-KDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB1","description":"ICD-CBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9088","description":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert ureteral support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50605","description":"Insert ureteral support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB1","description":"ICD-KEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD1","description":"ICD-JFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of osteocalcin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83937","description":"Assay of osteocalcin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73220","description":"MRI uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9945","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82946","description":"Glucagon tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86931","description":"Frozen blood thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF0","description":"ICD-ABAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE1","description":"ICD-ACTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE241","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC0","description":"ICD-NAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD1","description":"ICD-EBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL06","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42415","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA1","description":"ICD-KGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD0","description":"ICD-JAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC1","description":"ICD-GERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA1","description":"ICD-GFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD1","description":"ICD-KIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21079","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD120","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9465","description":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth correct heart rhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41051","description":"Anesth correct heart rhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0283","description":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC0","description":"ICD-MGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ivig demo_ services/supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2052","description":"Ivig demo_ services/supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC0","description":"ICD-NFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB0","description":"ICD-GCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhere pos air press therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8851","description":"Adhere pos air press therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA0","description":"ICD-BGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB0","description":"ICD-IICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC1","description":"ICD-OIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5991","description":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA1","description":"ICD-DAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0982","description":"Back upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB0","description":"ICD-AECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE1","description":"ICD-DHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57105","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3930","description":"Hfo nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372U","description":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Filtered nebulizer admin set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7006","description":"Filtered nebulizer admin set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematopoietic nuclear tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79403","description":"Hematopoietic nuclear tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB0","description":"ICD-JIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA0","description":"ICD-BAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fix partial denture section","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9120","description":"Fix partial denture section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4C","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD1","description":"ICD-NJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA0","description":"ICD-CBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31367","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phys review of motion tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96004","description":"Phys review of motion tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transect pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33922","description":"Transect pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE1","description":"ICD-ADLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43229","description":"Esophagoscopy lesion ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB0","description":"ICD-CHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF1","description":"ICD-IBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protamine sulfate per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4802","description":"Protamine sulfate per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99151","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"removal of implant body not requiring bone removal or flap elevation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6105","description":"removal of implant body not requiring bone removal or flap elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE1","description":"ICD-JAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57000","description":"Exploration of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest wall lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19260","description":"Removal of chest wall lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23020","description":"Release shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE0","description":"ICD-JCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg > 48 sq in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6247","description":"Hydrogel drg > 48 sq in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9452","description":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB0","description":"ICD-HCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF1","description":"ICD-HERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spacer with mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8101","description":"Spacer with mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71260","description":"Ct thorax w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA1","description":"ICD-EHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19287","description":"Perq dev breast 1st mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix/repair pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57545","description":"Remove cervix/repair pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF1","description":"ICD-OJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE1","description":"ICD-OADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins/rep subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33270","description":"Ins/rep subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA1","description":"ICD-CHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF0","description":"ICD-KBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE1","description":"ICD-BHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fo pip dip no jt spr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3927","description":"Fo pip dip no jt spr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain lower leg bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27604","description":"Drain lower leg bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD1","description":"ICD-HEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE0","description":"ICD-HDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec coll non-blood:a/d test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0048","description":"Spec coll non-blood:a/d test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL02","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64494","description":"Inj paravert f jnt l/s 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC0","description":"ICD-MAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA1","description":"ICD-PKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC105","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA1","description":"ICD-JCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF0","description":"ICD-JIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC0","description":"ICD-OJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC0","description":"ICD-FICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE1","description":"ICD-MLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iliac art angio_cardiac cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0278","description":"Iliac art angio_cardiac cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA1","description":"ICD-BFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF1","description":"ICD-PKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel new rubber standar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3460","description":"Shoe heel new rubber standar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA1","description":"ICD-FIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB1","description":"ICD-GFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA1","description":"ICD-NCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD1","description":"ICD-GFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE1","description":"ICD-MGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD0","description":"ICD-KDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF0","description":"ICD-JFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF0","description":"ICD-NKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB213","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49605","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB1","description":"ICD-GCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64600","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF0","description":"ICD-GDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB0","description":"ICD-BBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA1","description":"ICD-LDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21141","description":"Lefort i-1 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE1","description":"ICD-CGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC0","description":"ICD-GFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA0","description":"ICD-OLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME1","description":"ICD-FFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD254","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC130","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93356","description":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc brchiocph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237T","description":"Trluml perip athrc brchiocph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB0","description":"ICD-OGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38740","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44312","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF0","description":"ICD-CBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortobifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35646","description":"Art byp aortobifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0621","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF1","description":"ICD-GDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intestine lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44110","description":"Excise intestine lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE0","description":"ICD-BIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB1","description":"ICD-BHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF1","description":"ICD-JFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9896","description":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon beta-1a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1826","description":"Interferon beta-1a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hypothermia ill neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99184","description":"Hypothermia ill neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB1","description":"ICD-CIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC1","description":"ICD-OJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services provided in urgent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9088","description":"Services provided in urgent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4283","description":"Replacement breastpump cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA0","description":"ICD-OFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50060","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81305","description":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF0","description":"ICD-JDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0972T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","description":"CPT-0972T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC0","description":"ICD-NDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE0","description":"ICD-CHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC1","description":"ICD-OAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF0","description":"ICD-FGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE0","description":"ICD-LAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0811T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB154","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC0","description":"ICD-CEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB1","description":"ICD-CCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited ankle motion ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2200","description":"Limited ankle motion ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE112","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA1","description":"ICD-OCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt has docd immun to hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3515F","description":"Pt has docd immun to hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB1","description":"ICD-CCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92641","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","description":"CPT-92641","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No reason_ no refer hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9526","description":"No reason_ no refer hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of corticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82528","description":"Assay of corticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA1","description":"ICD-FIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC1","description":"ICD-JBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0802","description":"CDT-D0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27511","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF0","description":"ICD-KGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB245","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE1","description":"ICD-MLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA1","description":"ICD-NKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB0","description":"ICD-MFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","description":"HCPCS-E1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genetic test spec analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0423","description":"Genetic test spec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36510","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF0","description":"ICD-JIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB0","description":"ICD-FDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE0","description":"ICD-MJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB0","description":"ICD-CAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9561","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0560U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","description":"CPT-0560U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE1","description":"ICD-NJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC1","description":"ICD-GAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE0","description":"ICD-CIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD1","description":"ICD-OKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64902","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest vein for bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35500","description":"Harvest vein for bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF1","description":"ICD-CEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB1","description":"ICD-JFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim spinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0748","description":"Elec osteogen stim spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96160","description":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND1","description":"ICD-GFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6004","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB0","description":"ICD-ECLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9892","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD1","description":"ICD-KDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43121","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate finger w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26340","description":"Manipulate finger w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA31","description":"ICD-4HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9730","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA1","description":"ICD-LAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0470","description":"Fqhc visit_ mh estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC0","description":"ICD-CHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86832","description":"Hla class i high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 pc ost pou w built-in conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5057","description":"1 pc ost pou w built-in conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB0","description":"ICD-LARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC115","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC0","description":"ICD-PDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3A","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC0","description":"ICD-CIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA0","description":"ICD-DEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61315","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20702","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31205","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD0","description":"ICD-FBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB116","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0619","description":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB0","description":"ICD-NADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA0","description":"ICD-OFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF0","description":"ICD-KFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND1","description":"ICD-KHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA0","description":"ICD-KBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22845","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6445","description":"Conform band s w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB1","description":"ICD-OEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4301F","description":"Pt not rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Truskin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4167","description":"Truskin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80435","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC1","description":"ICD-KHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","description":"CPT-00474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF1","description":"ICD-CFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED0","description":"ICD-ABED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315T","description":"Rmvl vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF1","description":"ICD-CIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ initial rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9001","description":"Mccd_ initial rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE0","description":"ICD-FFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF1","description":"ICD-OCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC0","description":"ICD-EAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1346","description":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2D","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD1","description":"ICD-KGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC0","description":"ICD-GINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro cut ejacul duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52402","description":"Cystourethro cut ejacul duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES125","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44147","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC56","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA0","description":"ICD-KFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB0","description":"ICD-GDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD1","description":"ICD-JCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB1","description":"ICD-JAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51530","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound closure by adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0168","description":"Wound closure by adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA0","description":"ICD-OBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF1","description":"ICD-MHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33814","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC1","description":"ICD-DGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 2999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4723","description":"Dialys sol fld vol > 2999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD0","description":"ICD-JCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB0","description":"ICD-KCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF1","description":"ICD-GAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair testis injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54670","description":"Repair testis injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD0","description":"ICD-KGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC1","description":"ICD-KFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF1","description":"ICD-IFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF0","description":"ICD-PBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36815","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess dyspnea present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1019F","description":"Assess dyspnea present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB1","description":"ICD-LAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF0","description":"ICD-EFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27306","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD1","description":"ICD-GFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF0","description":"ICD-OLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniotic membrane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2790","description":"Amniotic membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME1","description":"ICD-BAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9761","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25028","description":"Drainage of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC1","description":"ICD-AGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC0","description":"ICD-CGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB1","description":"ICD-BECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure ureter/bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50930","description":"Closure ureter/bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD1","description":"ICD-KGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA0","description":"ICD-ADCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9094","description":"Injection_ sutimlimab-jome_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA0","description":"ICD-OKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB1","description":"ICD-MKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA0","description":"ICD-GENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Res care_ nos waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2032","description":"Res care_ nos waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove forearm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25248","description":"Remove forearm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62256","description":"Remove brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD1","description":"ICD-FDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC1","description":"ICD-CALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No brst cncr dx min invasive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8877","description":"No brst cncr dx min invasive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD0","description":"ICD-JDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27594","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA0","description":"ICD-AGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyst eval not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9608","description":"Intraop cyst eval not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE1","description":"ICD-GHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA1","description":"ICD-KIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96912","description":"Photochemotherapy with uv-a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE0","description":"ICD-NEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED0","description":"ICD-GIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36215","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open ablate liver tumor cryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47381","description":"Open ablate liver tumor cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reciprocating peritoneal dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1630","description":"Reciprocating peritoneal dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB1","description":"ICD-BBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB1","description":"ICD-LCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD0","description":"ICD-CHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal seg width > 28","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2319","description":"Lens trifocal seg width > 28","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE0","description":"ICD-GDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF1","description":"ICD-PLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA1","description":"ICD-FGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB0","description":"ICD-NCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aor ane 5.5-5.9 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9598","description":"Aor ane 5.5-5.9 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1952","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","description":"HCPCS-L1952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA0","description":"ICD-BBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD1","description":"ICD-IFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23031","description":"Drain shoulder bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood freeze/thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86932","description":"Frozen blood freeze/thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69145","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9305","description":"HCPCS-C9305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD1","description":"ICD-ICTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE1","description":"ICD-KBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4047","description":"Cast sup sht leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC0","description":"ICD-MABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC0","description":"ICD-NFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhs/hospice of rn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0299","description":"Hhs/hospice of rn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","description":"CPT-01936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001M","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ischm stroke symp ge3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1066F","description":"Ischm stroke symp ge3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE1","description":"ICD-PAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC1","description":"ICD-KAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open bowel to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44300","description":"Open bowel to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA02","description":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","description":"CPT-00922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC1","description":"ICD-KCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD0","description":"ICD-OFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0828","description":"Pwc gp 2 xtra hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME1","description":"ICD-EIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64766","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for maintenance of insulin infusion catheter_ per week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4224","description":"Supplies for maintenance of insulin infusion catheter_ per week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cbt 1st hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94644","description":"Cbt 1st hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable retainer adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8681","description":"Removable retainer adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no elig for bp assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8784","description":"Pt no elig for bp assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD1","description":"ICD-OGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81192","description":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rerevise eye muscles add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67332","description":"Rerevise eye muscles add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rna tstng hepc vir ord/docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3265F","description":"Rna tstng hepc vir ord/docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC1","description":"ICD-DIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluphenazine decanoate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2680","description":"Fluphenazine decanoate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11311","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX05","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No ret for surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9307","description":"No ret for surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pentamidine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2545","description":"Pentamidine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB1","description":"ICD-OAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37191","description":"Ins endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6532","description":"Compression stocking bk40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg (Cinqair)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9481","description":"Injection_ reslizumab_ 1 mg (Cinqair)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group therapeutic procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97150","description":"Group therapeutic procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD1","description":"ICD-BCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB1","description":"ICD-GBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc expectant management pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9053","description":"Onc expectant management pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA0","description":"ICD-LFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part removal hip bone deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27071","description":"Part removal hip bone deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA1","description":"ICD-BALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0651","description":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE215","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB03","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC134","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE0","description":"ICD-NAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB0","description":"ICD-EIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6752","description":"Crown porcelain noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA0","description":"ICD-EGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No oder pjp for med reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9219","description":"No oder pjp for med reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24362","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB0","description":"ICD-GETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA1","description":"ICD-ECMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC1","description":"ICD-NCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35361","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53251","description":"Anesth vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE0","description":"ICD-KHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1261","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inhaled corticosteroids rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4140F","description":"Inhaled corticosteroids rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC1","description":"ICD-EGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB0","description":"ICD-PJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD0","description":"ICD-LCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA0","description":"ICD-JDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA1","description":"ICD-EBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8A","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD0","description":"ICD-JFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply surf ldr radionuclide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77789","description":"Apply surf ldr radionuclide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair stern/nuss w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21742","description":"Repair stern/nuss w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforced solid stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2260","description":"Reinforced solid stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63055","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procainamide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2690","description":"Procainamide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD0","description":"ICD-IHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1930","description":"Afo plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF1","description":"ICD-CCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone mineral single photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78350","description":"Bone mineral single photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC1","description":"ICD-MCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC1","description":"ICD-OGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED0","description":"ICD-KBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30462","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF1","description":"ICD-JAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caffeine citrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0706","description":"Caffeine citrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE0","description":"ICD-FBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21630","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27246","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD0","description":"ICD-ABHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB1","description":"ICD-CBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF0","description":"ICD-GCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1603","description":"HCPCS-B1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Teflon or equal cable lining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6665","description":"Teflon or equal cable lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23335","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD0","description":"ICD-DIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9789","description":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19366","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB1","description":"ICD-OIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE0","description":"ICD-NDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58520","description":"Repair of ruptured uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA0","description":"ICD-BGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA0","description":"ICD-OEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Riv3 vaccine no preserv im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90673","description":"Riv3 vaccine no preserv im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA1","description":"ICD-GDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC0","description":"ICD-GDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0705","description":"Transfer device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1806","description":"HCPCS-B1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC1","description":"ICD-GCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34201","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF0","description":"ICD-CECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methadone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1230","description":"Methadone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback train any meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90901","description":"Biofeedback train any meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace chest compress vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7025","description":"Replace chest compress vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF1","description":"ICD-CHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA0","description":"ICD-BALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC40","description":"Ultra High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA0","description":"ICD-GEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB1","description":"ICD-OCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56625","description":"Complete removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB1","description":"ICD-PFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip canad sing axi cons fric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5250","description":"Hip canad sing axi cons fric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA0","description":"ICD-OJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE0","description":"ICD-KDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES213","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperbaric o2 chamber disps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4575","description":"Hyperbaric o2 chamber disps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC1","description":"ICD-JANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC1","description":"ICD-MJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB11","description":"ICD-1EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iloprost non-comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4074","description":"Iloprost non-comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB0","description":"ICD-IETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF1","description":"ICD-NALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC0","description":"ICD-CIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","description":"CPT-00190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of jaw bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21044","description":"Removal of jaw bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE1","description":"ICD-KGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF1","description":"ICD-BDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9165","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB215","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conversion ext bil drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47535","description":"Conversion ext bil drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME1","description":"ICD-ICME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE0","description":"ICD-NCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92990","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA0","description":"ICD-OAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF1","description":"ICD-CEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC0","description":"ICD-OHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC1","description":"ICD-GFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spirmtry w/brnchdil inf-2 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94012","description":"Spirmtry w/brnchdil inf-2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Camp day waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2037","description":"Camp day waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA0","description":"ICD-GHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC1","description":"ICD-JHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory flow volume loop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94375","description":"Respiratory flow volume loop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4450","description":"Non-waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF0","description":"ICD-PFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apically positioned flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4245","description":"Apically positioned flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried symp resp insuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1503F","description":"Pt queried symp resp insuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cms medical evidence form 2728 for dialysis patients: initial form completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1265","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC0","description":"ICD-ABEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2160","description":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker crutch attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0157","description":"Walker crutch attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB0","description":"ICD-CFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55860","description":"Surgical exposure prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC1","description":"ICD-KBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17651","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9445","description":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9937","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA0","description":"ICD-JDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA0","description":"ICD-CCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB1","description":"ICD-BDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abscess drainage under x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75989","description":"Abscess drainage under x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE1","description":"ICD-IFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA1","description":"ICD-NIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF1","description":"ICD-KAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC0","description":"ICD-PKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1054","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25300","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26591","description":"Repair muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67805","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81515","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","description":"CPT-81515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC0","description":"ICD-OHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revita_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4180","description":"Revita_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peripheral nerve block (PNB)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9770","description":"Peripheral nerve block (PNB)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC211","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0652T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE0","description":"ICD-BBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC1","description":"ICD-AIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB1","description":"ICD-ECEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED1","description":"ICD-KDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF1","description":"ICD-KHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA1","description":"ICD-KEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1288","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 31/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99449","description":"Interprof phone/online 31/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID0","description":"ICD-GGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB1","description":"ICD-KHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko swedish type pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1850","description":"Ko swedish type pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11300","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD0","description":"ICD-FBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc md rsn no antipla/p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9610","description":"Doc md rsn no antipla/p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5945","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5945","description":"CDT-D5945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF0","description":"ICD-CACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6114","description":"Implnt/abut fixed dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF0","description":"ICD-NFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF0","description":"ICD-PJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q24h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9500","description":"Hit antibiotic q24h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC54","description":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37268","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","description":"CPT-37268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5D","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0601","description":"CDT-D0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE0","description":"ICD-MEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27894","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis test procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81099","description":"Urinalysis test procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA1","description":"ICD-CFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","description":"CPT-55714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438U","description":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlh w/t/o 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58571","description":"Tlh w/t/o 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE1","description":"ICD-KCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD1","description":"ICD-NLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38571","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1450","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","description":"HCPCS-M1450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9155","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313U","description":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55180","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD1","description":"ICD-BEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advnc care plan tlk docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1158F","description":"Advnc care plan tlk docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA1","description":"ICD-GDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA23","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crisis interven svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2011","description":"Crisis interven svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF1","description":"ICD-NBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert remov molded spe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3001","description":"Foot insert remov molded spe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC0","description":"ICD-JEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of burn scab initi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16035","description":"Incision of burn scab initi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME0","description":"ICD-FGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2400","description":"Chloroprocaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE1","description":"ICD-GEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD0","description":"ICD-DAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB1","description":"ICD-CESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test hemidiaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95866","description":"Muscle test hemidiaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD1","description":"ICD-CDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RenoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4321","description":"RenoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc prosth taa add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33884","description":"Endovasc prosth taa add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD0","description":"ICD-MHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE1","description":"ICD-NEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF0","description":"ICD-HIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43117","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC1","description":"ICD-GHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF0","description":"ICD-KFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3D","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97810","description":"Acupunct w/o stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB1","description":"ICD-KGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB212","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE1","description":"ICD-NKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA01","description":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA1","description":"ICD-KCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL45","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD0","description":"ICD-NECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB1","description":"ICD-NCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesions 2 to 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11056","description":"Trim skin lesions 2 to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD134","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF0","description":"ICD-BDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25025","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC1","description":"ICD-MJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24579","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77771","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF0","description":"ICD-CCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA1","description":"ICD-EHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF0","description":"ICD-KEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA0","description":"ICD-CAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA0","description":"ICD-KFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE0","description":"ICD-NGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF1","description":"ICD-PCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE0","description":"ICD-JEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic cust fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0484","description":"Tlso rigid plastic cust fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endo shows barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3140F","description":"Upper gi endo shows barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD0","description":"ICD-AICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB1","description":"ICD-JCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE0","description":"ICD-OHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB40","description":"Very High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33901","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD213","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE1","description":"ICD-CBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC0","description":"ICD-FAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA1","description":"ICD-KCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD116","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA11","description":"ICD-3EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5282","description":"Removable unilateral partial denture - one piece cast metal_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE0","description":"ICD-MGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB1","description":"ICD-FDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9176","description":"HCPCS-C9176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB02","description":"Medium Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","description":"CPT-01942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55865","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement facemask interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7031","description":"Replacement facemask interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA0","description":"ICD-EHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23146","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB1","description":"ICD-DHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA1","description":"ICD-GCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE0","description":"ICD-BHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD0","description":"ICD-GFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0743T","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD0","description":"ICD-FDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD1","description":"ICD-FAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc rect tum transanal part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45171","description":"Exc rect tum transanal part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA1","description":"ICD-LFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67010","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD1","description":"ICD-GHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27269","description":"Optx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF0","description":"ICD-KHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF1","description":"ICD-CFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Card output measure subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93562","description":"Card output measure subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA1","description":"ICD-JBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 50NCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91306","description":"SARSCOV2 VAC 50NCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD117","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE1","description":"ICD-OGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE125","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC1","description":"ICD-AEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB1","description":"ICD-NGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF0","description":"ICD-OCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC1","description":"ICD-PDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55867","description":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50340","description":"Removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC0","description":"ICD-OLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF0","description":"ICD-FACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9795","description":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD1","description":"ICD-NKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF1","description":"ICD-PIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC120","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC1","description":"ICD-OEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99224","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26180","description":"Removal of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9041","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD0","description":"ICD-KIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA0","description":"ICD-MFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time otr method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85348","description":"Coagulation time otr method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85461","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA11","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD0","description":"ICD-FDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462U","description":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2471","description":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE220","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE1","description":"ICD-EHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient transferred to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9826","description":"Patient transferred to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0162","description":"Ondansetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1078T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1078T","description":"CPT-1078T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61512","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA1","description":"ICD-CBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemipelvectomy canadian sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5341","description":"Hemipelvectomy canadian sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE0","description":"ICD-NJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD1","description":"ICD-IAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93980","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33940","description":"Removal of donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95170","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD1","description":"ICD-EGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE0","description":"ICD-KIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0985T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","description":"CPT-0985T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wedging of clubfoot cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29750","description":"Wedging of clubfoot cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA1","description":"ICD-LFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11403","description":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB1","description":"ICD-EEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE0","description":"ICD-BBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA0","description":"ICD-CBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 3/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80363","description":"Opioids & opiate analogs 3/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj tedizolid phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3090","description":"Inj tedizolid phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95120","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF1","description":"ICD-OLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF0","description":"ICD-GBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML44","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20701","description":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20604","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA1","description":"ICD-FAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nutri counsel-control caries","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1310","description":"Nutri counsel-control caries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA0","description":"ICD-MACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC1","description":"ICD-OGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml dx status unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9139","description":"Onc dx cml dx status unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0323U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5133","description":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD1","description":"ICD-OGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA0","description":"ICD-JAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9346","description":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Copd symptoms assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1015F","description":"Copd symptoms assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB0","description":"ICD-FDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE1","description":"ICD-GEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF1","description":"ICD-IDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg strap each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0038","description":"Leg strap each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change nephroureteral cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50387","description":"Change nephroureteral cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct maxilla segment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7947","description":"Reconstruct maxilla segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endoscopy performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3130F","description":"Upper gi endoscopy performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4360","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","description":"HCPCS-Q4360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA0","description":"ICD-NEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF0","description":"ICD-MATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075T","description":"Perq stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC1","description":"ICD-OBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp ea duct/ampulla dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43277","description":"Ercp ea duct/ampulla dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96170","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD1","description":"ICD-FIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pinworm examinations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0113","description":"Pinworm examinations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD0","description":"ICD-JBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thrombin time plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85670","description":"Thrombin time plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","description":"HCPCS-L6038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8003","description":"HCPCS-C8003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF1","description":"ICD-OFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise tendon forearm/wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25109","description":"Excise tendon forearm/wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5B","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB1","description":"ICD-CADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual funct status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1055F","description":"Visual funct status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA1","description":"ICD-MHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE0","description":"ICD-OBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB0","description":"ICD-HESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0998T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","description":"CPT-0998T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD1","description":"ICD-IABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE1","description":"ICD-GIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0902","description":"HCPCS-B0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62651","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC0","description":"ICD-LBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA0","description":"ICD-GERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB1","description":"ICD-NAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1203","description":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD0","description":"ICD-GGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC0","description":"ICD-FCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD1","description":"ICD-GBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27193","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA0","description":"ICD-JAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place po breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19296","description":"Place po breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB0","description":"ICD-HAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0953","description":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iv pole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0776","description":"Iv pole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of rhabdomyolysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9780","description":"Patients who have a diagnosis of rhabdomyolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD1","description":"ICD-OKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF0","description":"ICD-JGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF1","description":"ICD-OEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supported housing_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0044","description":"Supported housing_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5841","description":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp w/fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46258","description":"Remove in/ex hem grp w/fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF0","description":"ICD-NEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA0","description":"ICD-EBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC104","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nutritional counseling_ diet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9470","description":"Nutritional counseling_ diet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD0","description":"ICD-KBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64581","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD1","description":"ICD-GIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Offset/lat rocker arm w/ela","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2632","description":"Offset/lat rocker arm w/ela","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB1","description":"ICD-KBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC1","description":"ICD-GITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert subq exten to ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49435","description":"Insert subq exten to ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC1","description":"ICD-BCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB1","description":"ICD-FANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9738","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD1","description":"ICD-NBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA0","description":"ICD-NGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21123","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0206","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise diaphragm nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64746","description":"Incise diaphragm nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF1","description":"ICD-OJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC1","description":"ICD-BHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abduction rotation bar shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3140","description":"Abduction rotation bar shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20245","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc rf ablate renal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50592","description":"Perc rf ablate renal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC1","description":"ICD-NKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95717","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85730","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33947","description":"Ecmo/ecls initiation artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD0","description":"ICD-NCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asthma measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8645","description":"Asthma measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap sleeve gastrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43775","description":"Lap sleeve gastrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC1","description":"ICD-KGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD0","description":"ICD-PISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2D","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: headache radiating to the neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2190","description":"Patients with clinical indications for imaging of the head: headache radiating to the neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA1","description":"ICD-GFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA24","description":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC1","description":"ICD-BDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc leukoreduced irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9040","description":"Rbc leukoreduced irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9939","description":"Placement of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF1","description":"ICD-MFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB155","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF1","description":"ICD-OEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA1","description":"ICD-CFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA1","description":"ICD-NCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE1","description":"ICD-NIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC0","description":"ICD-FHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD0","description":"ICD-CEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3352","description":"Apexification/recalc interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA0","description":"ICD-AITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD1","description":"ICD-LGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BellaCell HD or Surederm_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4220","description":"BellaCell HD or Surederm_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow inter loc elbow forarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6250","description":"Elbow inter loc elbow forarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 21 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP21","description":"Auto test panel pricing code_ 21 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC1","description":"ICD-NIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54800","description":"Biopsy of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB1","description":"ICD-JDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE0","description":"ICD-FCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC0","description":"ICD-PJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22868","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF1","description":"ICD-FCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl&rplcmt ss impl dfb pg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0614T","description":"Rmvl&rplcmt ss impl dfb pg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0364","description":"Cone beam ct capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16<=48 no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6223","description":"Gauze >16<=48 no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA44","description":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED1","description":"ICD-NLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compounded drug not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9977","description":"Compounded drug not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3002","description":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF1","description":"ICD-OFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB1","description":"ICD-JGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair & revise nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64874","description":"Repair & revise nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE1","description":"ICD-MHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD234","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00174","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","description":"CPT-00174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2B","description":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE0","description":"ICD-FDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52234","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap insert tunnel ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49324","description":"Lap insert tunnel ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paranasal sinus ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9024","description":"Paranasal sinus ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rsa lower extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350T","description":"Rsa lower extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC0","description":"ICD-HFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD0","description":"ICD-BGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA52","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30999","description":"Nasal surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD0","description":"ICD-ABUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF1","description":"ICD-BHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC0","description":"ICD-OIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA0","description":"ICD-OBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF0","description":"ICD-GAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA1","description":"ICD-AALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1210","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76984","description":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD1","description":"ICD-DFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 9-10 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98929","description":"Osteopath manj 9-10 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB0","description":"ICD-EFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD0","description":"ICD-DFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complex drainage wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10180","description":"Complex drainage wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB0","description":"ICD-LGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF0","description":"ICD-KBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC0","description":"ICD-GHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","description":"CPT-00812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9743","description":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87803","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27005","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX33","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE1","description":"ICD-CGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp&up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51729","description":"Cystometrogram w/vp&up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84203","description":"Test rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD1","description":"ICD-IELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97166","description":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arformoterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7605","description":"Arformoterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA07","description":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24665","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB1","description":"ICD-NFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF1","description":"ICD-GFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA0","description":"ICD-MGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF0","description":"ICD-BEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC1","description":"ICD-KEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE1","description":"ICD-EEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE0","description":"ICD-CGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter w/bag 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4313","description":"Catheter w/bag 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8B","description":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0667","description":"Seg pneumatic appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB1","description":"ICD-NLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of sternum separation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21750","description":"Repair of sternum separation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC1","description":"ICD-MBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5922","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD1","description":"ICD-NJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE0","description":"ICD-GFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC0","description":"ICD-KAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ alfentanil hydrochloride_ 500 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0216","description":"Injection_ alfentanil hydrochloride_ 500 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaccine toxoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90749","description":"Vaccine toxoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth rem bony w/comp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7241","description":"Impact tooth rem bony w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD0","description":"ICD-NELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE1","description":"ICD-NKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost sknbar w/o conv<=4 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4414","description":"Ost sknbar w/o conv<=4 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF1","description":"ICD-CEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC1","description":"ICD-OBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0734T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD0","description":"ICD-EBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewings two films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0272","description":"Dental bitewings two films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF0","description":"ICD-ACCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE0","description":"ICD-ADAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF1","description":"ICD-KGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC0","description":"ICD-ODDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE0","description":"ICD-PGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC1","description":"ICD-KAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61608","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ep & ablate ventric tachy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93654","description":"Ep & ablate ventric tachy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB150","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81362","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC1","description":"ICD-CAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA0","description":"ICD-BIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF1","description":"ICD-MJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81560","description":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE1","description":"ICD-CCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0233","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","description":"HCPCS-M0233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE0","description":"ICD-CBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below/above elbow lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6698","description":"Below/above elbow lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC0","description":"ICD-DAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA0","description":"ICD-CGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD1","description":"ICD-BFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-serv of pt_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0151","description":"Hhcp-serv of pt_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1500","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","description":"HCPCS-M1500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF1","description":"ICD-JBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF0","description":"ICD-LIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1003","description":"HCPCS-B1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE1","description":"ICD-GHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD244","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC0","description":"ICD-LBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant tcat pulm vlv perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33477","description":"Implant tcat pulm vlv perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC0","description":"ICD-BDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00834","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","description":"CPT-00834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3213","description":"Benesch boot pair child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB46","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB1","description":"ICD-IGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2327","description":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE0","description":"ICD-NAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD1","description":"ICD-DBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC0","description":"ICD-FAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF0","description":"ICD-LDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD1","description":"ICD-FBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0078U","description":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF1","description":"ICD-ICCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB1","description":"ICD-BGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC0","description":"ICD-BDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF1","description":"ICD-GADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Somatrem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2940","description":"Somatrem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD1","description":"ICD-MKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD0","description":"ICD-OHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB1","description":"ICD-IAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us b w/non-quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76512","description":"Ophth us b w/non-quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD1","description":"ICD-FCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA1","description":"ICD-GBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB1","description":"ICD-KGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB1","description":"ICD-OHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB1","description":"ICD-OKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degrade semiquant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85378","description":"Fibrin degrade semiquant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF1","description":"ICD-OBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC11","description":"ICD-2EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA1","description":"ICD-FBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB1","description":"ICD-AIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA1","description":"ICD-IECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME1","description":"ICD-IBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0759T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE246","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ggt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82977","description":"Assay of ggt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43247","description":"Egd remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA45","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC1","description":"ICD-JFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB1","description":"ICD-FFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q8h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9502","description":"Hit antibiotic q8h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","description":"HCPCS-Q4396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE0","description":"ICD-CEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72156","description":"MRI neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF0","description":"ICD-GDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC1","description":"ICD-CHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0869","description":"Pwc gp 4 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD0","description":"ICD-CFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Throat x-ray & fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70370","description":"Throat x-ray & fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67961","description":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Miscellaneous component_ supply or accessory for use with total artificial heart system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8698","description":"Miscellaneous component_ supply or accessory for use with total artificial heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA0","description":"ICD-BBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC0","description":"ICD-KGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES301","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE0","description":"ICD-NGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cltx thigh fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27268","description":"Cltx thigh fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise windpipe scar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31830","description":"Revise windpipe scar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE0","description":"ICD-KAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21209","description":"Reduction of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8I","description":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA1","description":"ICD-FAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME1","description":"ICD-CDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q2058","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","description":"HCPCS-Q2058","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal m1 w/mets prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9094","description":"Onc dx rectal m1 w/mets prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81297","description":"Msh2 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC1","description":"ICD-OJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0150U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD1","description":"ICD-BGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter for hysterography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58340","description":"Catheter for hysterography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 1 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72081","description":"X-ray exam entire spi 1 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impreg gauze no h20/sal/yard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6266","description":"Impreg gauze no h20/sal/yard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20693","description":"Adjust bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair semi-recl detach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1110","description":"Wheelchair semi-recl detach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE1","description":"ICD-JBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5169","description":"HCPCS-Q5169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB1","description":"ICD-JGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penis plastic surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54360","description":"Penis plastic surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB1","description":"ICD-BCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273U","description":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE1","description":"ICD-KAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Direct advanced life support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99288","description":"Direct advanced life support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB0","description":"ICD-JIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB0","description":"ICD-AHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML24","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA254","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB1","description":"ICD-ABLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD0","description":"ICD-GEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84488","description":"Test feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE0","description":"ICD-JHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0860T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6077","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE0","description":"ICD-GGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE0","description":"ICD-CHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51050","description":"Removal of bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC0","description":"ICD-MBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC210","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID0","description":"ICD-GIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE1","description":"ICD-IIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61607","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5D","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE0","description":"ICD-NKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE1","description":"ICD-MJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC1","description":"ICD-PEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electro hearng aid test one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92594","description":"Electro hearng aid test one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB0","description":"ICD-KAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA52","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB1","description":"ICD-GBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8E","description":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA1","description":"ICD-OEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0489U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","description":"CPT-0489U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0552T","description":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF1","description":"ICD-BITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC1","description":"ICD-OLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE1","description":"ICD-OBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE0","description":"ICD-CIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC1","description":"ICD-KFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB1","description":"ICD-JDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB0","description":"ICD-MBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0666U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0666U","description":"CPT-0666U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC1","description":"ICD-NILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD0","description":"ICD-KGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Menacwy vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90734","description":"Menacwy vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF1","description":"ICD-EBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Htlv/hiv confirmj antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86689","description":"Htlv/hiv confirmj antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76882","description":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC0","description":"ICD-KHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA1","description":"ICD-NDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF1","description":"ICD-KDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD1","description":"ICD-CIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC1","description":"ICD-BDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC1","description":"ICD-CCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA1","description":"ICD-PEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE0","description":"ICD-JFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor x stuart-power","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85260","description":"Clot factor x stuart-power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA1","description":"ICD-OJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instr xrcz back pain 12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4240F","description":"Instr xrcz back pain 12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17260","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC1","description":"ICD-NBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31081","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-52597","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","description":"CPT-52597","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF1","description":"ICD-NLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0173","description":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD1","description":"ICD-EDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC1","description":"ICD-ACDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA1","description":"ICD-MBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec seat depth/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1298","description":"Wheelchair spec seat depth/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44660","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17272","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE1","description":"ICD-CEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41825","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528T","description":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile ducts/pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74300","description":"X-ray bile ducts/pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA1","description":"ICD-OGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9002","description":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB1","description":"ICD-KHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with no clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1031","description":"Patients with no clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC0","description":"ICD-DFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE0","description":"ICD-OHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND0","description":"ICD-GHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA1","description":"ICD-OJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fna w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10021","description":"Fna w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB135","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc spinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61783","description":"Scan proc spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vedolizumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80280","description":"Vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX24","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38129","description":"Laparoscope proc spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00534","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","description":"CPT-00534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME0","description":"ICD-AFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB1","description":"ICD-GCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37230","description":"Tib/per revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC42","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Simult panc kidn trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2065","description":"Simult panc kidn trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA1","description":"ICD-EITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1504","description":"HCPCS-C1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB0","description":"ICD-OFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA0","description":"ICD-GGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD0","description":"ICD-BFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplemental electrical test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92547","description":"Supplemental electrical test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA0","description":"ICD-KFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF0","description":"ICD-EFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA1","description":"ICD-PASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA1","description":"ICD-KDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE0","description":"ICD-CEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA1","description":"ICD-FFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ pheresis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9034","description":"Platelets_ pheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB1","description":"ICD-NAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF1","description":"ICD-FDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF0","description":"ICD-ODIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD1","description":"ICD-MIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27538","description":"Treat knee fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3386","description":"HCPCS-J3386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB0","description":"ICD-PERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC0","description":"ICD-NCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ventral hern init block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49561","description":"Rpr ventral hern init block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA0","description":"ICD-KENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0318U","description":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC1","description":"ICD-CHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD0","description":"ICD-CHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF0","description":"ICD-NFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF1","description":"ICD-FAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD1","description":"ICD-OKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB0","description":"ICD-EHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10012","description":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE0","description":"ICD-KAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Homecare train pt session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5109","description":"Homecare train pt session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE1","description":"ICD-GGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB0","description":"ICD-GECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA0","description":"ICD-CIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC31","description":"ICD-1BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE1","description":"ICD-CCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj pls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409T","description":"Insj/rplc cardiac modulj pls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA0","description":"ICD-FEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1160","description":"Digoxin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF0","description":"ICD-HEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repr elbw med ligmnt w/tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24345","description":"Repr elbw med ligmnt w/tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In vivo lab service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88749","description":"In vivo lab service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB0","description":"ICD-GGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA0","description":"ICD-EAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF1","description":"ICD-CFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","description":"HCPCS-M1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA1","description":"ICD-CDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28300","description":"Incision of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","description":"HCPCS-J3392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD1","description":"ICD-OHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23660","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF1","description":"ICD-LIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0857T","description":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mst rcnt hbb < 10g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8973","description":"Mst rcnt hbb < 10g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC0","description":"ICD-MEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC12","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1322","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1046","description":"Functional status measurement with score was not obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC0","description":"ICD-KIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID0","description":"ICD-IBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF1","description":"ICD-CDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB0","description":"ICD-CCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB1","description":"ICD-BFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86318","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD1","description":"ICD-GEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE1","description":"ICD-OGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB0","description":"ICD-KDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast thermoplas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2126","description":"Kafo fem fx cast thermoplas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED0","description":"ICD-MEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB0","description":"ICD-AEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA0","description":"ICD-JILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB1","description":"ICD-HGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA0","description":"ICD-GHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fixed ht w/ mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0250","description":"Hosp bed fixed ht w/ mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pneum/hydra pneum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5780","description":"Knee-shin pneum/hydra pneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC1","description":"ICD-MHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA1","description":"ICD-GACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag w/o liv/kid/adr les","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9551","description":"Abd imag w/o liv/kid/adr les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC1","description":"ICD-AHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA1","description":"ICD-NGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF1","description":"ICD-JFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal 4.00/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2306","description":"Lens sphcyl trifocal 4.00/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8H","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99392","description":"Prev visit est age 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81514","description":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB0","description":"ICD-KHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch for bar w lk fl/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4423","description":"Ost pch for bar w lk fl/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Path consult introp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88329","description":"Path consult introp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA0","description":"ICD-NIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versitiâ„¢ Comprehensive Bleeding Disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272U","description":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versitiâ„¢ Comprehensive Bleeding Disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexmedetomidine_ oral_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1105","description":"Dexmedetomidine_ oral_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD1","description":"ICD-MHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC0","description":"ICD-NFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB0","description":"ICD-DBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA0","description":"ICD-GAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE0","description":"ICD-NIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC1","description":"ICD-PKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC1","description":"ICD-IEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA0","description":"ICD-ACTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA1","description":"ICD-CCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj brachial plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64415","description":"N block inj brachial plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehabilitation progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9472","description":"Cardiac rehabilitation progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD210","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00300","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","description":"CPT-00300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA1","description":"ICD-BHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA1","description":"ICD-OLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD201","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE1","description":"ICD-JBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA11","description":"ICD-3AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9485","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD0","description":"ICD-PHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF0","description":"ICD-CHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compression form shoe insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5510","description":"Compression form shoe insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20900","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA1","description":"ICD-DDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","description":"HCPCS-G0566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duodenal exclusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48547","description":"Duodenal exclusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Out of office emerg med serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99060","description":"Out of office emerg med serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD0","description":"ICD-GBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB1","description":"ICD-CCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA1","description":"ICD-EDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE1","description":"ICD-GAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cangrelor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9460","description":"Injection_ cangrelor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED0","description":"ICD-EFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA0","description":"ICD-PBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD0","description":"ICD-JFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral aprepitant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8501","description":"Oral aprepitant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB0","description":"ICD-NFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD1","description":"ICD-JEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA1","description":"ICD-CAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice home care in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5010","description":"Hospice home care in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424T","description":"Insj/rplc nstim apnea compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86036","description":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motor function mapping ntms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310T","description":"Motor function mapping ntms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF0","description":"ICD-CGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36456","description":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88264","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shortening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27465","description":"Shortening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1155","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOSPORIDIUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87328","description":"IAAD IA CRYPTOSPORIDIUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA0","description":"ICD-OIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE1","description":"ICD-KDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF0","description":"ICD-EFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker variable wheel resist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0147","description":"Walker variable wheel resist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidural lysis on single day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62264","description":"Epidural lysis on single day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF0","description":"ICD-CHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood feces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82270","description":"Occult blood feces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92934","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compressor air power source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0565","description":"Compressor air power source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50561","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC0","description":"ICD-NBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1239","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC0","description":"ICD-EBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF0","description":"ICD-IHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF0","description":"ICD-NIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA1","description":"ICD-NGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF1","description":"ICD-LEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF1","description":"ICD-IADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC1","description":"ICD-EATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0745T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF1","description":"ICD-OCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69140","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC1","description":"ICD-OJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289T","description":"Laser inc for pkp/lkp donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE0","description":"ICD-LFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB1","description":"ICD-GDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specimen site not prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8798","description":"Specimen site not prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51585","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had more than one emergency department visit in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9850","description":"Patient had more than one emergency department visit in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive ear/neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69155","description":"Extensive ear/neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC0","description":"ICD-NDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD1","description":"ICD-ACHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA1","description":"ICD-KHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC106","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE1","description":"ICD-NCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50431","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB1","description":"ICD-OHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC0","description":"ICD-EABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB0","description":"ICD-OBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF1","description":"ICD-HFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA1","description":"ICD-KAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE0","description":"ICD-CCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB0","description":"ICD-PDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sincalide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2805","description":"Sincalide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep trk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15002","description":"Wound prep trk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC1","description":"ICD-BBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA0","description":"ICD-ICUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43216","description":"Esophagoscopy lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD1","description":"ICD-EEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37254","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","description":"CPT-37254","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC1","description":"ICD-GEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF1","description":"ICD-NGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB1","description":"ICD-FGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA1","description":"ICD-PHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC0","description":"ICD-PFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB1","description":"ICD-ABUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy remove adnexa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58661","description":"Laparoscopy remove adnexa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0D","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE0","description":"ICD-CHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE0","description":"ICD-CFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF1","description":"ICD-NLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87110","description":"Chlamydia culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc of pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9250","description":"Doc of pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD0","description":"ICD-FGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF0","description":"ICD-EATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC0","description":"ICD-DCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC1","description":"ICD-CCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel face epiderm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15788","description":"Chemical peel face epiderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53275","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF1","description":"ICD-GEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB1","description":"ICD-ABEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF1","description":"ICD-ODKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flotufolastat F-18_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9156","description":"Flotufolastat F-18_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81002","description":"Urinalysis nonauto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB1","description":"ICD-OJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47136","description":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic prop tire insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2213","description":"Pneumatic prop tire insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA0","description":"ICD-BFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA0","description":"ICD-BDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB1","description":"ICD-LHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA0","description":"ICD-BBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX03","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF1","description":"ICD-GCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disp home glucose monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9275","description":"Disp home glucose monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1611","description":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1A","description":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED1","description":"ICD-MHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE1","description":"ICD-FCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot longitudinal arch suppo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3010","description":"Foot longitudinal arch suppo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC0","description":"ICD-NJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF1","description":"ICD-AIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sorbent cartridges per 10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1636","description":"Sorbent cartridges per 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE0","description":"ICD-BIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL56","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical placement: zygomatic implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7994","description":"Surgical placement: zygomatic implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA0","description":"ICD-CCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3244","description":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD0","description":"ICD-JAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC1","description":"ICD-NCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3C","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Primary closure sinus perf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7261","description":"Primary closure sinus perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA1","description":"ICD-KEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluzone vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2038","description":"Fluzone vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81257","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exercise equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9300","description":"Exercise equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE0","description":"ICD-CIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stainless steel any wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6630","description":"Stainless steel any wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53431","description":"Reconstruct urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9778","description":"Patients who have a diagnosis of pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal hemoglobin chemical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83030","description":"Fetal hemoglobin chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0694U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694U","description":"CPT-0694U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD1","description":"ICD-ECBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE1","description":"ICD-OKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA1","description":"ICD-DCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF1","description":"ICD-OAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0684","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","description":"HCPCS-G0684","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4521","description":"Adult size brief/diaper sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20983","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toc tool incl key elem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9655","description":"Toc tool incl key elem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Integra bmwd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4104","description":"Integra bmwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rotary wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0436","description":"Rotary wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2401","description":"Injection_ chloroprocaine hydrochloride_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43118","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC0","description":"ICD-IHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78710","description":"Kidney imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33915","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE0","description":"ICD-OHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0794T","description":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD1","description":"ICD-MCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Root amputation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3450","description":"Root amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC0","description":"ICD-OAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC11","description":"ICD-1GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA1","description":"ICD-PBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA11","description":"ICD-4KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ipilimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9228","description":"Ipilimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9536","description":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC1","description":"ICD-MDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65781","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fistula repair & colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57307","description":"Fistula repair & colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoskeletal axial rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5984","description":"Endoskeletal axial rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins bone device for rsa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347T","description":"Ins bone device for rsa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL15","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Buttock fasciotomy w/dbrdmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27057","description":"Buttock fasciotomy w/dbrdmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD1","description":"ICD-OACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37229","description":"Tib/per revasc w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC1","description":"ICD-GIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath therapeutic irrig agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4321","description":"Cath therapeutic irrig agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venipuncture home/snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9529","description":"Venipuncture home/snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF0","description":"ICD-OLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hernia repair w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49568","description":"Hernia repair w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence product_ disposable_ penile wrap_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4545","description":"Incontinence product_ disposable_ penile wrap_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE0","description":"ICD-BEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of creatine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82540","description":"Assay of creatine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/ch access anti-rollback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0974","description":"W/ch access anti-rollback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE0","description":"ICD-DBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4530","description":"Ped size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE1","description":"ICD-KGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB1","description":"ICD-NFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Set-up cardiovert-defibrill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93745","description":"Set-up cardiovert-defibrill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF1","description":"ICD-MHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76989","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate sol test kit_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4760","description":"Dialysate sol test kit_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB0","description":"ICD-OAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ga67 gallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9556","description":"Ga67 gallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros_ urinary sph_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1815","description":"Pros_ urinary sph_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC0","description":"ICD-OLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB1","description":"ICD-EADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1 mic or T1a documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9704","description":"AJCC breast cancer stage I: T1 mic or T1a documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25126","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1004","description":"Pwr seat recline mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63286","description":"Bx/exc idrl imed lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF1","description":"ICD-ECDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin w/high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6250","description":"Bridge resin w/high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87913","description":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28113","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12007","description":"Rpr s/n/ax/gen/trnk >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB0","description":"ICD-CCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9076","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","description":"HCPCS-J9076","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA1","description":"ICD-CILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Migration inhibitory factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86378","description":"Migration inhibitory factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC0","description":"ICD-OGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40720","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Growth stimulation gene 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83006","description":"Growth stimulation gene 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB1","description":"ICD-PAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC216","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC1","description":"ICD-CCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA1","description":"ICD-NBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF1","description":"ICD-CHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound exam follow-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76970","description":"Ultrasound exam follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8I","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8697","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8697","description":"HCPCS-L8697","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA1","description":"ICD-KDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66761","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE0","description":"ICD-CGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF0","description":"ICD-FFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4B","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not medically necessary svc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9986","description":"Not medically necessary svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF0","description":"ICD-AGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA1","description":"ICD-IAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE0","description":"ICD-OEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL07","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us guidance fetal reduct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8055","description":"Us guidance fetal reduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB26","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD1","description":"ICD-AETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1557","description":"HCPCS-L1557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE1","description":"ICD-ACDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE0","description":"ICD-KGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE0","description":"ICD-HBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9756","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC0","description":"ICD-GIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","description":"HCPCS-A4545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD212","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc advncd dis comfort 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1152F","description":"Doc advncd dis comfort 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0592","description":"Buprenorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4030","description":"Pulmonology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD1","description":"ICD-FBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE0","description":"ICD-GIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD1","description":"ICD-OHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD1","description":"ICD-OCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA0","description":"ICD-GHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt access bil tree sm bwl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47541","description":"Plmt access bil tree sm bwl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA1","description":"ICD-FHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement bile duct support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47801","description":"Placement bile duct support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE1","description":"ICD-CIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF1","description":"ICD-GBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC1","description":"ICD-OHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0838","description":"Pwc gp 2 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23140","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA0","description":"ICD-FICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF0","description":"ICD-NEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387U","description":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA1","description":"ICD-OHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6446","description":"Conform band s w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert cath pleura w/ image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32557","description":"Insert cath pleura w/ image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE0","description":"ICD-KHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/o he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1406","description":"O2/water vapor enrich w/o he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap resect s/intestine addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44203","description":"Lap resect s/intestine addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED0","description":"ICD-MFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydration iv infusion init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96360","description":"Hydration iv infusion init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE1","description":"ICD-KALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0660","description":"Pneumatic appliance full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF0","description":"ICD-GFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2d6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81226","description":"Cyp2d6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35081","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA0","description":"ICD-CHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8430","description":"Prosthetic sock multi ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA1","description":"ICD-LDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE0","description":"ICD-IHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70496","description":"Ct angiography head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF0","description":"ICD-LGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE1","description":"ICD-FEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0549","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","description":"HCPCS-G0549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB0","description":"ICD-GGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98000","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","description":"CPT-98000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB1","description":"ICD-CFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90867","description":"Tcranial magn stim tx plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC0","description":"ICD-KDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC0","description":"ICD-BCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC0","description":"ICD-HGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA0","description":"ICD-GDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular stim for shock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0745","description":"Neuromuscular stim for shock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD0","description":"ICD-AFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME0","description":"ICD-KGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID0","description":"ICD-MAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC1","description":"ICD-NEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD1","description":"ICD-MHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0571T","description":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76376","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB0","description":"ICD-PAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1502","description":"CDT-D1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 1200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0244","description":"Injection_ casirivimab and imdevimab_ 1200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plaelet rich plasma unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9020","description":"Plaelet rich plasma unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1826","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","description":"HCPCS-E1826","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4C","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC1","description":"ICD-JFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE0","description":"ICD-PJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0848T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Full mouth debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4355","description":"Full mouth debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29840","description":"Wrist arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED0","description":"ICD-OEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE1","description":"ICD-CEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC0","description":"ICD-EEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/o implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21406","description":"Opn tx orbit fx w/o implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB1","description":"ICD-KAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC1","description":"ICD-JABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD1","description":"ICD-GCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF0","description":"ICD-DEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alteplase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2997","description":"Alteplase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC1","description":"ICD-OHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD0","description":"ICD-BHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB0","description":"ICD-IFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63600","description":"Remove spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE0","description":"ICD-IAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm tum deep < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25076","description":"Exc forearm tum deep < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC1","description":"ICD-FCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC0","description":"ICD-BHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID1","description":"ICD-ABID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD0","description":"ICD-FAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Odontoplasty 1-2 teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9971","description":"Odontoplasty 1-2 teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap ing hernia repair init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49650","description":"Lap ing hernia repair init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA1","description":"ICD-CEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92287","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA0","description":"ICD-KARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB1","description":"ICD-AHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9768","description":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA1","description":"ICD-CCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE211","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath closure of vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93581","description":"Transcath closure of vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36470","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA0","description":"ICD-CDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB1","description":"ICD-BDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE1","description":"ICD-AALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ethanolamine oleate 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1430","description":"Ethanolamine oleate 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ moxifloxacin 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2280","description":"Inj_ moxifloxacin 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC0","description":"ICD-FFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF1","description":"ICD-BEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA1","description":"ICD-NENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27675","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD124","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500T","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC1","description":"ICD-OINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD134","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2510","description":"Th/wght bear quad-lat brim m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays adrenals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75733","description":"Artery x-rays adrenals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC1","description":"ICD-OLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex h rate for sz ovr 30 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385T","description":"Ex h rate for sz ovr 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA0","description":"ICD-BFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE1","description":"ICD-OHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No sig dep symp by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3352F","description":"No sig dep symp by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78701","description":"Kidney imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012U","description":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC0","description":"ICD-KAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC111","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01990","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","description":"CPT-01990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF0","description":"ICD-KASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED1","description":"ICD-NKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alemtuzumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9010","description":"Alemtuzumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC1","description":"ICD-MJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sympt sten-tia/strk<120days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9006F","description":"Sympt sten-tia/strk<120days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF0","description":"ICD-CAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml chronic phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9123","description":"Onc dx cml chronic phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatic elastase fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82656","description":"Pancreatic elastase fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smoker/exposed 2nd hnd smoke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1032F","description":"Smoker/exposed 2nd hnd smoke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC0","description":"ICD-MGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA1","description":"ICD-OGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC0","description":"ICD-FGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA1","description":"ICD-CHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4331","description":"Axolotl Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA0","description":"ICD-OFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31553","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF0","description":"ICD-LCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection glatiramer acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1595","description":"Injection glatiramer acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post vert arthrplst 1 lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202T","description":"Post vert arthrplst 1 lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86309","description":"Heterophile antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth upper gi visualize","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74051","description":"Anesth upper gi visualize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11424","description":"Exc h-f-nk-sp b9+marg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA0","description":"ICD-OAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB1","description":"ICD-BELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE1","description":"ICD-METE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-noprogress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9074","description":"Onc dx brst stg3-noprogress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA0","description":"ICD-BDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB0","description":"ICD-MLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","description":"HCPCS-M1411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7516","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00928","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","description":"CPT-00928","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63283","description":"Bx/exc idrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable nebulizer sml vol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7004","description":"Disposable nebulizer sml vol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC0","description":"ICD-AABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99202","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex type 2 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86696","description":"Herpes simplex type 2 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orth newington","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1710","description":"Legg perthes orth newington","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB1","description":"ICD-OLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC1","description":"ICD-JCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc (colorectal)_ quant assess of three urine metabolites by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002U","description":"Onc (colorectal)_ quant assess of three urine metabolites by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5103","description":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest lining biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52251","description":"Anesth chest lining biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE1","description":"ICD-KIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID0","description":"ICD-OKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27725","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heparin-protamine tolerance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85530","description":"Heparin-protamine tolerance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject l ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93565","description":"Inject l ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrcp talk b/4 antiv txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4159F","description":"Contrcp talk b/4 antiv txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC0","description":"ICD-OJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF0","description":"ICD-KGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD1","description":"ICD-KGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45100","description":"Biopsy of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46762","description":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA02","description":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artificial cornea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8609","description":"Artificial cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE0","description":"ICD-NJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Outer ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69399","description":"Outer ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 4th stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0342","description":"Lifestyle mod 4th stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD0","description":"ICD-GDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC0","description":"ICD-MLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70547","description":"Mr angiography neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF1","description":"ICD-NBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF0","description":"ICD-CFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC0","description":"ICD-NKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE1","description":"ICD-EADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD1","description":"ICD-KFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0494","description":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2067","description":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA0","description":"ICD-KCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96156","description":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF1","description":"ICD-FGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE0","description":"ICD-BBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC0","description":"ICD-PJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB0","description":"ICD-GEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laundry serv_ext_prof_/order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5175","description":"Laundry serv_ext_prof_/order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA1","description":"ICD-KELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33945","description":"Transplantation of heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB1","description":"ICD-JHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lancets per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4259","description":"Lancets per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD1","description":"ICD-EBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF0","description":"ICD-KECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB1","description":"ICD-NCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD1","description":"ICD-OLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB21","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA1","description":"ICD-MHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m sestamibi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9500","description":"Tc99m sestamibi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC1","description":"ICD-EDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB1","description":"ICD-NHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified drug or biological used for ESRD on dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3591","description":"Unclassified drug or biological used for ESRD on dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE0","description":"ICD-JGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC0","description":"ICD-EITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC1","description":"ICD-EGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB220","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC0","description":"ICD-CCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC1","description":"ICD-OBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64804","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA0","description":"ICD-NIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC1","description":"ICD-BIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42505","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face tum deep 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21014","description":"Exc face tum deep 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex for nonspeech device rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92605","description":"Ex for nonspeech device rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex dx brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43197","description":"Esophagoscopy flex dx brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED0","description":"ICD-BBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB0","description":"ICD-JHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA1","description":"ICD-KBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF0","description":"ICD-OKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disease activity not assessed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1006","description":"Disease activity not assessed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8871","description":"Patient not receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE1","description":"ICD-NKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA0","description":"ICD-IBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA1","description":"ICD-PEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF0","description":"ICD-FHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA0","description":"ICD-LASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF0","description":"ICD-EBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF0","description":"ICD-CHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE1","description":"ICD-KDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA0","description":"ICD-GGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF1","description":"ICD-IDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB1","description":"ICD-FCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35180","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD1","description":"ICD-NAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB1","description":"ICD-NGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF1","description":"ICD-DIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF1","description":"ICD-FGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER QUAN IMAGING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207U","description":"NEURO ALZHEIMER QUAN IMAGING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC1","description":"ICD-EBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive vaginal ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7303","description":"Contraceptive vaginal ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cephapirin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0710","description":"Cephapirin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305U","description":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42500","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87557","description":"M.tuberculo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE1","description":"ICD-CEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB0","description":"ICD-OFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB0","description":"ICD-PGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","description":"CPT-00630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA1","description":"ICD-GDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1195","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj tbo filgrastim 1 microg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1447","description":"Inj tbo filgrastim 1 microg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC0","description":"ICD-NIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA0","description":"ICD-FFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF0","description":"ICD-FDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9951","description":"Limited occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE1","description":"ICD-NEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA0","description":"ICD-KBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE1","description":"ICD-MEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE0","description":"ICD-KICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin & tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15839","description":"Excise excess skin & tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID0","description":"ICD-FGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB0","description":"ICD-NHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1001","description":"CDT-D1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML12","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28150","description":"Removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES120","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Freeing of bowel adhesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44005","description":"Freeing of bowel adhesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of s/l path_ea 15mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0153","description":"Hhcp-svs of s/l path_ea 15mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43825","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB1","description":"ICD-EBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE1","description":"ICD-JHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF0","description":"ICD-CCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF0","description":"ICD-GDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID0","description":"ICD-CEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE1","description":"ICD-AIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB0","description":"ICD-JGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93152","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipid profile not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8728","description":"Lipid profile not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC1","description":"ICD-OCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap ing hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49651","description":"Lap ing hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE0","description":"ICD-ODLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF1","description":"ICD-ACBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging mult areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78801","description":"Tumor imaging mult areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD1","description":"ICD-CFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthes w/o adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8030","description":"Breast prosthes w/o adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB1","description":"ICD-NIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72133","description":"Ct lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL14","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand-held pefr meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4614","description":"Hand-held pefr meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC0","description":"ICD-GFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspend bowel w/prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44700","description":"Suspend bowel w/prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9061","description":"Injection_ amivantamab-vmjw_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg scrn dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3351F","description":"Neg scrn dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX26","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peak expiratory flow rate (p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8110","description":"Peak expiratory flow rate (p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF0","description":"ICD-KGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC1","description":"ICD-GHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC150","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD1","description":"ICD-GDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD0","description":"ICD-GFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF0","description":"ICD-BAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF0","description":"ICD-OCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD0","description":"ICD-KAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA31","description":"ICD-1JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cord blood harvesting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2140","description":"Cord blood harvesting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE1","description":"ICD-JGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation tx delivery imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6015","description":"Radiation tx delivery imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE215","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Silvr oxide batt glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4236","description":"Silvr oxide batt glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE1","description":"ICD-GALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Idet 1 or more levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22527","description":"Idet 1 or more levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9780","description":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD0","description":"ICD-JACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us guide tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76940","description":"Us guide tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC1","description":"ICD-GGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB0","description":"ICD-KFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cryofibrinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82585","description":"Assay of cryofibrinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA1","description":"ICD-CGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","description":"CPT-01520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1233","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC0","description":"ICD-GGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1295","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bio imm resp mod presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9506","description":"Bio imm resp mod presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA STREPTOCOCCUS GROUP A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87430","description":"IAAD IA STREPTOCOCCUS GROUP A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC1","description":"ICD-CHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB1","description":"ICD-OEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0302","description":"HCPCS-C0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB0","description":"ICD-FGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium succ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1720","description":"Hydrocortisone sodium succ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD135","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA0","description":"ICD-OGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","description":"HCPCS-M1406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB1","description":"ICD-OHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9834","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch and cane holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2207","description":"Crutch and cane holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE0","description":"ICD-GDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD0","description":"ICD-GDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF1","description":"ICD-JGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0925T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","description":"CPT-0925T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID1","description":"ICD-FBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD1","description":"ICD-OABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64835","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE1","description":"ICD-EBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect distal humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24150","description":"Resect distal humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD1","description":"ICD-OFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF0","description":"ICD-BHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE0","description":"ICD-BEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE1","description":"ICD-CIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA11","description":"ICD-1FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB1","description":"ICD-KALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC0","description":"ICD-DHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE1","description":"ICD-NJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD1","description":"ICD-PLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE1","description":"ICD-OILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier 8x8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5122","description":"Solid skin barrier 8x8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE0","description":"ICD-KIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF1","description":"ICD-KAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB0","description":"ICD-CGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hypertonic saline sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7131","description":"Hypertonic saline sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB0","description":"ICD-OAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB1","description":"ICD-FIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE1","description":"ICD-CABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD1","description":"ICD-GDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35521","description":"Art byp grft axill-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE1","description":"ICD-FFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA0","description":"ICD-CCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB0","description":"ICD-NCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC1","description":"ICD-IBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD0","description":"ICD-FBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery transpose/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33889","description":"Artery transpose/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-33882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","description":"CPT-33882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit day life activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99509","description":"Home visit day life activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB0","description":"ICD-KFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD0","description":"ICD-IFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biphos thxpy vein ord/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4100F","description":"Biphos thxpy vein ord/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE0","description":"ICD-OCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD0","description":"ICD-FDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE0","description":"ICD-OGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2192","description":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD0","description":"ICD-KBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1470","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","description":"HCPCS-M1470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No elig ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8857","description":"No elig ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"D&c of cervical stump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57558","description":"D&c of cervical stump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary service/procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94799","description":"Pulmonary service/procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Er/ip hosp =/>2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9522","description":"Er/ip hosp =/>2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD0","description":"ICD-JFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision and/or reinsertion of transhepatic tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47530","description":"Revision and/or reinsertion of transhepatic tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nusinersen_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2326","description":"Injection_ nusinersen_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD0","description":"ICD-CGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD0","description":"ICD-KIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ & train 1 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98960","description":"Self-mgmt educ & train 1 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF1","description":"ICD-FFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE1","description":"ICD-JDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair head rest extensi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0966","description":"Wheelchair head rest extensi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD0","description":"ICD-CCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB0","description":"ICD-BGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37799","description":"Vascular surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC0","description":"ICD-JGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ (aponvie)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9145","description":"Injection_ aprepitant_ (aponvie)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE0","description":"ICD-FEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB144","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD0","description":"ICD-JCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB246","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE1","description":"ICD-BFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/thymus resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32673","description":"Thoracoscopy w/thymus resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33779","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC1","description":"ICD-EHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31574","description":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA1","description":"ICD-EEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC1","description":"ICD-GIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD0","description":"ICD-NHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA1","description":"ICD-DCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30430","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE1","description":"ICD-KDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7730","description":"Open reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA1","description":"ICD-FHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA1","description":"ICD-CBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/o bag 2-way silicone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4312","description":"Cath w/o bag 2-way silicone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE1","description":"ICD-FFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contour back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2293","description":"Contour back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alglucosidase alfa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0220","description":"Alglucosidase alfa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0578","description":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE0","description":"ICD-BHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD111","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1173","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC0","description":"ICD-FIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA1","description":"ICD-MDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB0","description":"ICD-KFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fistula cannulation set_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4730","description":"Fistula cannulation set_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93284","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB0","description":"ICD-OITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID1","description":"ICD-FEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone hexacetonl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3303","description":"Triamcinolone hexacetonl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter w/o bag 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4311","description":"Catheter w/o bag 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE0","description":"ICD-GBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB0","description":"ICD-IEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA0","description":"ICD-IBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No knee/ankle joints w/ ft b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5210","description":"No knee/ankle joints w/ ft b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA0","description":"ICD-KECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF0","description":"ICD-GEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC1","description":"ICD-ACCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB1","description":"ICD-KISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE0","description":"ICD-OBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB1","description":"ICD-OLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE0","description":"ICD-KCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB1","description":"ICD-KCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","description":"HCPCS-A2032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA1","description":"ICD-CFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev_ passive hand mitt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6703","description":"Term dev_ passive hand mitt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE0","description":"ICD-KEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX05","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE1","description":"ICD-GBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA0","description":"ICD-EBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89259","description":"Cryopreservation sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43415","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA1","description":"ICD-GEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic sentence test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92576","description":"Synthetic sentence test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE1","description":"ICD-BEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE0","description":"ICD-NAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED0","description":"ICD-FFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA1","description":"ICD-NHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD1","description":"ICD-CFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27390","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD0","description":"ICD-FEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES244","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC0","description":"ICD-JATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE0","description":"ICD-PCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD1","description":"ICD-CFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ramucirumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9308","description":"Injection_ ramucirumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD0","description":"ICD-AIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA0","description":"ICD-GBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67924","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serotonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84260","description":"Assay of serotonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD1","description":"ICD-MBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC1","description":"ICD-FHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA1","description":"ICD-KAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med reas pt_ pn_ not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8722","description":"Med reas pt_ pn_ not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE0","description":"ICD-ABDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36012","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64561","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"F18 fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9552","description":"F18 fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC0","description":"ICD-OCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA33","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA1","description":"ICD-ECLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens spher bifoc plano 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2200","description":"Lens spher bifoc plano 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA1","description":"ICD-OFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skills training and development_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2038","description":"Skills training and development_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE1","description":"ICD-AABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral 50% dextrose solu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4164","description":"Parenteral 50% dextrose solu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD0","description":"ICD-BDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial rotation unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5986","description":"Multi-axial rotation unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME0","description":"ICD-JFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33231","description":"Insrt pulse gen w/mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23615","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD221","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB0","description":"ICD-BENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA0","description":"ICD-KFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA1","description":"ICD-JEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69000","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1312","description":"Patient not screened for tobacco use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC1","description":"ICD-KFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC1","description":"ICD-CIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer care checklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583F","description":"Transfer care checklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1059T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1059T","description":"CPT-1059T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF0","description":"ICD-OFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF1","description":"ICD-CBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92628","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","description":"CPT-92628","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA0","description":"ICD-IICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tacrol astagraf ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7508","description":"Tacrol astagraf ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC1","description":"ICD-KFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1C","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81329","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45111","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1282","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Primatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4110","description":"Primatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB1","description":"ICD-NAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB0","description":"ICD-NLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp duct stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43274","description":"Ercp duct stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB1","description":"ICD-JHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB0","description":"ICD-KGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0D","description":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF1","description":"ICD-GHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA1","description":"ICD-PFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breast pump shield","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4284","description":"Replcmnt breast pump shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj new drug addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96375","description":"Tx/pro/dx inj new drug addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83788","description":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC0","description":"ICD-FDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD1","description":"ICD-DDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF0","description":"ICD-NIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA1","description":"ICD-FGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3501","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB1","description":"ICD-FAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1005","description":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin ac_ 1 cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4141","description":"Alloskin ac_ 1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urtr inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9631","description":"Urtr inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21120","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB0","description":"ICD-GFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB1","description":"ICD-FDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA0","description":"ICD-FBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC0","description":"ICD-JFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81005","description":"Urinalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD1","description":"ICD-EDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE0","description":"ICD-CDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neutralization test viral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86382","description":"Neutralization test viral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8I","description":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84075","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC0","description":"ICD-KELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA1","description":"ICD-FBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE0","description":"ICD-OETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD0","description":"ICD-NFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD0","description":"ICD-NJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA0","description":"ICD-NJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC1","description":"ICD-OLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE1","description":"ICD-HFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC1","description":"ICD-NCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX13","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3B","description":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD1","description":"ICD-EATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0260","description":"Hosp bed semi-electr w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy contrl bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32654","description":"Thoracoscopy contrl bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0245U","description":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD0","description":"ICD-GIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil sup empl waiver 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2019","description":"Habil sup empl waiver 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB0","description":"ICD-KDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB1","description":"ICD-NGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC0","description":"ICD-GGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE1","description":"ICD-ICTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD1","description":"ICD-OHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX12","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker monitr audible/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0610","description":"Pacemaker monitr audible/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD0","description":"ICD-MDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF1","description":"ICD-ABUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA1","description":"ICD-KHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF1","description":"ICD-GGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC0","description":"ICD-JDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradation products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85362","description":"Fibrin degradation products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0078","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB1","description":"ICD-NIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sanopellis_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4308","description":"Sanopellis_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81236","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of CHA2DS2-VASc risk score of 0 or 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9931","description":"Documentation of CHA2DS2-VASc risk score of 0 or 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC0","description":"ICD-OBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF0","description":"ICD-IEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2638","description":"Brachytx_ stranded_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB0","description":"ICD-FHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE1","description":"ICD-CIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC0","description":"ICD-NBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA1","description":"ICD-OCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54348","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","description":"CPT-01924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA1","description":"ICD-CBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD0","description":"ICD-CGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99234","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC0","description":"ICD-OCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA31","description":"ICD-3DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no dicom format doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9329","description":"Norsn no dicom format doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27161","description":"Incision of neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF1","description":"ICD-AHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1090","description":"Lumbar sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE0","description":"ICD-KGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1725","description":"Cath_ translumin non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD0","description":"ICD-OCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB1","description":"ICD-ODLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB1","description":"ICD-IBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE0","description":"ICD-ODDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA0","description":"ICD-MKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA1","description":"ICD-OJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB1","description":"ICD-CFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla x-match noncytotoxc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86826","description":"Hla x-match noncytotoxc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC0","description":"ICD-NIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE1","description":"ICD-CGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE0","description":"ICD-FGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE1","description":"ICD-FFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB1","description":"ICD-JCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 22+ classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0483","description":"Drug test def 22+ classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1C","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1701","description":"HCPCS-B1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX24","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA1","description":"ICD-GHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE1","description":"ICD-OBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB0","description":"ICD-CAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch forearm each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0111","description":"Crutch forearm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59850","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF1","description":"ICD-OJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF1","description":"ICD-KDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","description":"HCPCS-M0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye image valid to dx rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2026F","description":"Eye image valid to dx rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No antipla/p2y12 ord_ rs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9611","description":"No antipla/p2y12 ord_ rs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF0","description":"ICD-MHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto rescreen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88148","description":"Cytopath c/v auto rescreen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD1","description":"ICD-MILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7565","description":"HCPCS-C7565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17273","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID1","description":"ICD-KHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF0","description":"ICD-DAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA1","description":"ICD-IEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0935T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","description":"CPT-0935T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6243","description":"Hydrogel drg >16<=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ arm_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6588","description":"Gradient pressure wrap with adjustable straps_ arm_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99308","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA0","description":"ICD-NAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB1","description":"ICD-HCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11622","description":"Exc s/n/h/f/g mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB1","description":"ICD-NKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD1","description":"ICD-GILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dual layer impax membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4262","description":"Dual layer impax membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27137","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA11","description":"ICD-1GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD1","description":"ICD-AAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore chest vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35820","description":"Explore chest vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA0","description":"ICD-CBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB0","description":"ICD-NJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92631","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","description":"CPT-92631","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB11","description":"ICD-3DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg >16<=48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6255","description":"Absorpt drg >16<=48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB1","description":"ICD-OEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81172","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF1","description":"ICD-AHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF0","description":"ICD-FDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC0","description":"ICD-BCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/femoroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29914","description":"Hip arthro w/femoroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE225","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA1","description":"ICD-GIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","description":"CPT-01920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculoplasty laser surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65855","description":"Trabeculoplasty laser surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD1","description":"ICD-CGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy of joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29999","description":"Arthroscopy of joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB12","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE1","description":"ICD-BALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiesse injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2026","description":"Radiesse injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA1","description":"ICD-FFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ alemtuzumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0202","description":"Injection_ alemtuzumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC0","description":"ICD-MJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID0","description":"ICD-NLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF0","description":"ICD-EAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC0","description":"ICD-GFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB1","description":"ICD-PHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE0","description":"ICD-GEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF0","description":"ICD-NGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroereisis_ subtalar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2117","description":"Arthroereisis_ subtalar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF1","description":"ICD-OFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE1","description":"ICD-OHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable corrugated tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7010","description":"Disposable corrugated tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB0","description":"ICD-LDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF1","description":"ICD-KATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nos quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110T","description":"Nos quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF0","description":"ICD-KCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26862","description":"Fusion/graft of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF0","description":"ICD-OCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND1","description":"ICD-NBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB1","description":"ICD-IALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA1","description":"ICD-AATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA1","description":"ICD-FEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE1","description":"ICD-NCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2014","description":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mmrv vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90710","description":"Mmrv vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME1","description":"ICD-NGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC1","description":"ICD-FIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC1","description":"ICD-KGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF0","description":"ICD-OKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63057","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB1","description":"ICD-FDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30545","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC236","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin pedicle flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15570","description":"Skin pedicle flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD1","description":"ICD-CDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37283","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","description":"CPT-37283","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnion bio or Axobiomembrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4211","description":"Amnion bio or Axobiomembrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC0","description":"ICD-BEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB1","description":"ICD-OFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4009","description":"Cast sup sht arm adult plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach supply noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8189","description":"Trach supply noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna hepatitis b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87912","description":"Genotype dna hepatitis b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA0","description":"ICD-ACMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose level test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0412","description":"Blood glucose level test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44376","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0602","description":"CDT-D0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD1","description":"ICD-FAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00454","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","description":"CPT-00454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB1","description":"ICD-HIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF1","description":"ICD-HIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61536","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDTB&VINCULIN IGG ANTB IA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0176U","description":"CDTB&VINCULIN IGG ANTB IA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","description":"CPT-01140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fast/dir ldl = 190 mg/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9663","description":"Fast/dir ldl = 190 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF0","description":"ICD-KABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED1","description":"ICD-NIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB1","description":"ICD-KGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83718","description":"Assay of lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF0","description":"ICD-EIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE1","description":"ICD-GITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC0","description":"ICD-GHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD1","description":"ICD-MBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB0","description":"ICD-CIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC1","description":"ICD-CBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB1","description":"ICD-MFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-2b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9214","description":"Interferon alfa-2b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE0","description":"ICD-NDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5253","description":"Hearing aid_ prog_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control unit bowel system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0350","description":"Control unit bowel system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB0","description":"ICD-MKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF1","description":"ICD-OHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC0","description":"ICD-BHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"T3 reverse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84482","description":"T3 reverse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24802","description":"Fusion/graft of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD0","description":"ICD-BGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calculus spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82365","description":"Calculus spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","description":"HCPCS-Q4413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID0","description":"ICD-NDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE0","description":"ICD-CEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck ext unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9112","description":"Onc dx head/neck ext unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF1","description":"ICD-LERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC0","description":"ICD-KDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA0","description":"ICD-NHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD0","description":"ICD-BDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Normal blood pressure reading documented_ follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1294","description":"Normal blood pressure reading documented_ follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE224","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE0","description":"ICD-BEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quick disconn hook adapter o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6628","description":"Quick disconn hook adapter o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE1","description":"ICD-OFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo urethral suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51990","description":"Laparo urethral suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26740","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE0","description":"ICD-MIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB140","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12057","description":"Intmd rpr face/mm >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radical resect abd tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22904","description":"Radical resect abd tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93246","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo frict swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5712","description":"Knee-shin exo frict swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE0","description":"ICD-OCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA1","description":"ICD-JGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB1","description":"ICD-FCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rep partial denture clasp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5630","description":"Rep partial denture clasp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF1","description":"ICD-GBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC1","description":"ICD-CAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous laser vein addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36479","description":"Endovenous laser vein addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ppps_ subseq visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0439","description":"Ppps_ subseq visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD234","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB1","description":"ICD-FFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB1","description":"ICD-FHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33946","description":"Ecmo/ecls initiation venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topical ox deliver sys_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0446","description":"Topical ox deliver sys_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"InnovaBurn or InnovaMatrix XL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2022","description":"InnovaBurn or InnovaMatrix XL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient education materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99071","description":"Patient education materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD1","description":"ICD-NJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF1","description":"ICD-DBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF0","description":"ICD-CDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","description":"HCPCS-G0557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD1","description":"ICD-OBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD1","description":"ICD-IIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD1","description":"ICD-OHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat larynx fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31584","description":"Treat larynx fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA0","description":"ICD-AAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC0","description":"ICD-MDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28130","description":"Removal of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD1","description":"ICD-GIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50394","description":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65880","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mohs surg addl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17315","description":"Mohs surg addl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF0","description":"ICD-JGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD1","description":"ICD-LCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC33","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bleeding time test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85002","description":"Bleeding time test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5149","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","description":"HCPCS-Q5149","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF1","description":"ICD-CIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC205","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC0","description":"ICD-CCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF0","description":"ICD-NCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD0","description":"ICD-MIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD0","description":"ICD-BFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB0","description":"ICD-KDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB1","description":"ICD-MKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD1","description":"ICD-EIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63655","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0742T","description":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral everolimus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7527","description":"Oral everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF1","description":"ICD-NCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1003","description":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE1","description":"ICD-MGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD0","description":"ICD-JGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA0","description":"ICD-MBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD1","description":"ICD-GGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF0","description":"ICD-BDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2D","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD1","description":"ICD-JFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Team evaluation & management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1024","description":"Team evaluation & management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB0","description":"ICD-OKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93616","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF1","description":"ICD-BBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87523","description":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE1","description":"ICD-GCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft ipsilat carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35501","description":"Art byp grft ipsilat carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue and mouth surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41599","description":"Tongue and mouth surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA0","description":"ICD-OGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power operated vehicle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1230","description":"Power operated vehicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD1","description":"ICD-JFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA1","description":"ICD-FHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0753T","description":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB1","description":"ICD-PISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB1","description":"ICD-BBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD0","description":"ICD-EIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC1","description":"ICD-GIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC13","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Installation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1894","description":"Personal Emergency Response System (Installation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0644T","description":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11313","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID1","description":"ICD-EGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC1","description":"ICD-KAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perphenazine 4mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0175","description":"Perphenazine 4mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF0","description":"ICD-HBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD0","description":"ICD-ABDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC1","description":"ICD-KDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density/peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77081","description":"Dxa bone density/peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27156","description":"Revision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA0","description":"ICD-NBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recement supp part denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6093","description":"Recement supp part denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acute hepatitis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80074","description":"Acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46260","description":"Remove in/ex hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA55","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF0","description":"ICD-JAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c acc_saf belt pelv strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0978","description":"W/c acc_saf belt pelv strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC1","description":"ICD-DBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF0","description":"ICD-OCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5110","description":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01360","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","description":"CPT-01360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9688","description":"Patients using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1175","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF0","description":"ICD-EHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery-vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36825","description":"Artery-vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND0","description":"ICD-KGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","description":"HCPCS-Q4382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB0","description":"ICD-MJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD0","description":"ICD-NIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF1","description":"ICD-DCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD1","description":"ICD-ICLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB0","description":"ICD-MJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC1","description":"ICD-KGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E3000","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63088","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC0","description":"ICD-KAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc of tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9276","description":"Doc of tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator chi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3206","description":"Hightop w/ supp/pronator chi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp geriatr assmt team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0250","description":"Comp geriatr assmt team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise submaxillary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42440","description":"Excise submaxillary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC1","description":"ICD-CAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD0","description":"ICD-OBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2D","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD1","description":"ICD-IBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern block < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49582","description":"Rpr umbil hern block < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-P9027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","description":"HCPCS-P9027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE0","description":"ICD-OCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF0","description":"ICD-BBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30400","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE1","description":"ICD-AEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of neonatal thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84437","description":"Assay of neonatal thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD0","description":"ICD-CBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF0","description":"ICD-FITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11102","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE0","description":"ICD-FBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD1","description":"ICD-NFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibuloplasty ridge extens","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7340","description":"Vestibuloplasty ridge extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35638","description":"Art byp aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD0","description":"ICD-FBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB1","description":"ICD-GABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF0","description":"ICD-BIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC0","description":"ICD-PASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF0","description":"ICD-LCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA1","description":"ICD-OJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE0","description":"ICD-GBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD250","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF1","description":"ICD-GCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2840","description":"Injection_ sebelipase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0750","description":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA1","description":"ICD-GDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA1","description":"ICD-GCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42665","description":"Ligation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair w/allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64910","description":"Nerve repair w/allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE1","description":"ICD-EBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45000","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD1","description":"ICD-HAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA1","description":"ICD-CIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC1","description":"ICD-NHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1011T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","description":"CPT-1011T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of pylorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43800","description":"Reconstruction of pylorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB11","description":"ICD-4BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete ivf nos case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4015","description":"Complete ivf nos case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA1","description":"ICD-AHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6023","description":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF1","description":"ICD-GENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA1","description":"ICD-IHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA1","description":"ICD-ABLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Matristem micromatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4118","description":"Matristem micromatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hinge ext/flex wrist finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3901","description":"Hinge ext/flex wrist finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36590","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family psytx w/patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90847","description":"Family psytx w/patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0571","description":"Buprenorphine oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF0","description":"ICD-EGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hand vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6708","description":"Term dev mech hand vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sitz bath/equipment w/faucet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0161","description":"Sitz bath/equipment w/faucet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC1","description":"ICD-EBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90283","description":"Human ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5A","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE1","description":"ICD-NKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gene expression profiling panel for use in the management of breast cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3854","description":"Gene expression profiling panel for use in the management of breast cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF1","description":"ICD-JIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE0","description":"ICD-CGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB1","description":"ICD-LAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso rem fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43194","description":"Esophagoscp rig trnso rem fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD0","description":"ICD-JCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7511","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Static str toe dev ext/flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1831","description":"Static str toe dev ext/flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL12","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging ltd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78102","description":"Bone marrow imaging ltd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9282","description":"Doc medrsn no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD0","description":"ICD-KCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp lesion ablate w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43278","description":"Ercp lesion ablate w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB0","description":"ICD-FHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA11","description":"ICD-2KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA1","description":"ICD-ABIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27695","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB216","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin node stgng docdb/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3323F","description":"Clin node stgng docdb/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE1","description":"ICD-GHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rails bed side full length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0310","description":"Rails bed side full length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB217","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF0","description":"ICD-OKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 65+ yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99387","description":"Init pm e/m new pat 65+ yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID0","description":"ICD-EEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF1","description":"ICD-IEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo pwr shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1008","description":"Pwr seat combo pwr shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC0","description":"ICD-ABLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0465","description":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9996","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","description":"HCPCS-Q9996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE0","description":"ICD-GAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE1","description":"ICD-OAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mohs addl stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17312","description":"Mohs addl stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF0","description":"ICD-NDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB60","description":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC1","description":"ICD-BETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC0","description":"ICD-KAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ famotidine_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0028","description":"Injection_ famotidine_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB1","description":"ICD-OFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaginectomy w/nodes compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57112","description":"Vaginectomy w/nodes compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9977","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF1","description":"ICD-CETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE1","description":"ICD-JDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC0","description":"ICD-GDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD1","description":"ICD-NAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA0","description":"ICD-DAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital observation per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0378","description":"Hospital observation per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD210","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diaphragm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4266","description":"Diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99191","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE0","description":"ICD-BGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision benign lesion compl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7412","description":"Excision benign lesion compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF0","description":"ICD-BBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC1","description":"ICD-NEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF0","description":"ICD-EHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92274","description":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB0","description":"ICD-CFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67922","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94777","description":"Ped home apnea rec report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD0","description":"ICD-KIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE0","description":"ICD-MKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1218","description":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE1","description":"ICD-EIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC0","description":"ICD-NIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND1","description":"ICD-FEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90692","description":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE0","description":"ICD-OBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA1","description":"ICD-NIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA1","description":"ICD-NJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC34","description":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88272","description":"Cytogenetics 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF0","description":"ICD-KBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8X","description":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD0","description":"ICD-BFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA1","description":"ICD-JDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger jnt add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26861","description":"Fusion of finger jnt add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","description":"HCPCS-M1400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF0","description":"ICD-BINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE0","description":"ICD-OJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex type 1 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86695","description":"Herpes simplex type 1 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36583","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21556","description":"Exc neck tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prfrmnc docd 2 wks b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3328F","description":"Prfrmnc docd 2 wks b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abx pres w/in 10 dys of symp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9505","description":"Abx pres w/in 10 dys of symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA0","description":"ICD-IITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD1","description":"ICD-EAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD0","description":"ICD-CCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1020T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","description":"CPT-1020T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35621","description":"Art byp axillary-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME0","description":"ICD-EEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD1","description":"ICD-OESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0663U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0663U","description":"CPT-0663U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90889","description":"Preparation of report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND1","description":"ICD-FCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF0","description":"ICD-KFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted maaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81599","description":"Unlisted maaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fats/lipids feces qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82705","description":"Fats/lipids feces qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD0","description":"ICD-DISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9280","description":"Mitomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fix g/colon tube w/device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49460","description":"Fix g/colon tube w/device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk20.1-30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12006","description":"Rpr s/n/a/gen/trk20.1-30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable soft interface le","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0672","description":"Removable soft interface le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB1","description":"ICD-FGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF0","description":"ICD-MJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA0","description":"ICD-GCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA0","description":"ICD-BDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB1","description":"ICD-JCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC0","description":"ICD-FCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD1","description":"ICD-KBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE0","description":"ICD-GIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD0","description":"ICD-OEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC1","description":"ICD-KARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE1","description":"ICD-DHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC0","description":"ICD-MAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD1","description":"ICD-EDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB0","description":"ICD-GEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology work-up evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9050","description":"Oncology work-up evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvas vasc dx study proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93998","description":"Noninvas vasc dx study proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD0","description":"ICD-GHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE0","description":"ICD-EHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD0","description":"ICD-OHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1201","description":"HCPCS-A1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us < 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76802","description":"Ob us < 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvis bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26991","description":"Drainage of pelvis bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/uro repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58293","description":"Vag hyst w/uro repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis equipment noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1699","description":"Dialysis equipment noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD135","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA1","description":"ICD-CEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE1","description":"ICD-NLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB105","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1mg (Empliciti)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9477","description":"Injection_ elotuzumab_ 1mg (Empliciti)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0528","description":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-62330","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","description":"CPT-62330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shock wv tx ms nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019T","description":"Extracorp shock wv tx ms nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF0","description":"ICD-OHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB0","description":"ICD-ADCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE0","description":"ICD-BHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD1","description":"ICD-NFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC1","description":"ICD-LAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Azathioprine parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7501","description":"Azathioprine parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB0","description":"ICD-KGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF1","description":"ICD-FICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB1","description":"ICD-PLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE1","description":"ICD-CGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA0","description":"ICD-BBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33852","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE0","description":"ICD-NFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89337","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3C","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac fb remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32658","description":"Thoracoscopy w/sac fb remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC0","description":"ICD-JEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00864","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","description":"CPT-00864","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Milwaukee type superstructur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1230","description":"Milwaukee type superstructur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC0","description":"ICD-EGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD1","description":"ICD-IGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0520","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0520","description":"HCPCS-Q0520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB0","description":"ICD-KBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject skin lesions >7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11901","description":"Inject skin lesions >7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61543","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0240","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80428","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9515","description":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA0","description":"ICD-PKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF1","description":"ICD-IBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0912","description":"Hd trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC1","description":"ICD-FHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA0","description":"ICD-GEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nvr cndj tst 1-2 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95907","description":"Nvr cndj tst 1-2 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE1","description":"ICD-ECHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36902","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture complete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5863","description":"Overdenture complete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1196","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446T","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB1","description":"ICD-NJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diaphragm surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39599","description":"Diaphragm surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9542","description":"Ht inj noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90389","description":"Tetanus ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary cath leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4334","description":"Urinary cath leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC1","description":"ICD-JCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE1","description":"ICD-BADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee lift loop drop lock rin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2492","description":"Knee lift loop drop lock rin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB31","description":"ICD-3KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB1","description":"ICD-LIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA206","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70330","description":"X-ray exam of jaw joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB1","description":"ICD-CICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (lyumjev)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1814","description":"Insulin (lyumjev)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0401","description":"HCPCS-A0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2642","description":"Brachytx_ stranded_ c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF1","description":"ICD-CHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF1","description":"ICD-PCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39503","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA0","description":"ICD-FBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81202","description":"Apc gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4367","description":"Ostomy belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42820","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF0","description":"ICD-MFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD1","description":"ICD-CELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB0","description":"ICD-MKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","description":"HCPCS-Q4394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF0","description":"ICD-CGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC1","description":"ICD-MBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF1","description":"ICD-JEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2140","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD0","description":"ICD-OLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA0","description":"ICD-GIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA1","description":"ICD-EDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No admit req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9413","description":"No admit req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD1","description":"ICD-HARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF0","description":"ICD-GIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED1","description":"ICD-EBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA0","description":"ICD-BHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lenacapavir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1961","description":"Injection_ lenacapavir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecallantide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1290","description":"Ecallantide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58580","description":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC0","description":"ICD-JFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","description":"CPT-92634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain for barrier fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4425","description":"Ost pch drain for barrier fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC1","description":"ICD-KITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF1","description":"ICD-CHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA1","description":"ICD-OCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE0","description":"ICD-OKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald telephone amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5268","description":"Ald telephone amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD1","description":"ICD-NKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF1","description":"ICD-KEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No mrs score in 90d followup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9647","description":"No mrs score in 90d followup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27487","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0892T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enter infusion pump w/o alrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9000","description":"Enter infusion pump w/o alrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF1","description":"ICD-DEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB1","description":"ICD-OBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF0","description":"ICD-PCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC1","description":"ICD-BBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE1","description":"ICD-FGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF1","description":"ICD-JBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81333","description":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44640","description":"Repair bowel-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC1","description":"ICD-NGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62200","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA0","description":"ICD-OAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC1","description":"ICD-PAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC1","description":"ICD-OIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2041","description":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27091","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB31","description":"ICD-4JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total lung lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32997","description":"Total lung lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA0","description":"ICD-CGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93317","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA1","description":"ICD-EEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21451","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/us guide bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45342","description":"Sigmoidoscopy w/us guide bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE0","description":"ICD-BIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid exam one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92590","description":"Hearing aid exam one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF1","description":"ICD-FADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD0","description":"ICD-EBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minoxidil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0139","description":"Minoxidil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration behind upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31040","description":"Exploration behind upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5160","description":"Dispensing fee binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE0","description":"ICD-OLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF1","description":"ICD-AACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD0","description":"ICD-OLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","description":"HCPCS-Q4351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57288","description":"Repair bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part hand myo exclu term dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6026","description":"Part hand myo exclu term dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC115","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elastic garment/covering","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4466","description":"Elastic garment/covering","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA0","description":"ICD-KATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26035","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD1","description":"ICD-IGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA0","description":"ICD-NCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22854","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tap block uni by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64487","description":"Tap block uni by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF1","description":"ICD-KICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving an anti-TNF agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9914","description":"Patient receiving an anti-TNF agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem odontogen cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7450","description":"Rem odontogen cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE1","description":"ICD-BDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC0","description":"ICD-KCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE244","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81184","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9052","description":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE1","description":"ICD-MAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skin tags 16 <=48 sq in w/bordr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6220","description":"Gauze >16 <=48 sq in w/bordr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn no stat tx/presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9667","description":"Doc med rsn no stat tx/presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB1","description":"ICD-KGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA1","description":"ICD-JAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC0","description":"ICD-KEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45905","description":"Dilation of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC0","description":"ICD-BIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF0","description":"ICD-OARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE0","description":"ICD-FELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF1","description":"ICD-AEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62000","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE0","description":"ICD-MAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES106","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch faceplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5053","description":"Clsd ostomy pouch faceplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE0","description":"ICD-NGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA1","description":"ICD-EDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC1","description":"ICD-FBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB0","description":"ICD-ODJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treponema pallidum ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87285","description":"Treponema pallidum ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC0","description":"ICD-FHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC0","description":"ICD-KEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA1","description":"ICD-NGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE120","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF0","description":"ICD-FEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61548","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA0","description":"ICD-FIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD1","description":"ICD-OBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE0","description":"ICD-OBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE1","description":"ICD-GCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosphenytoin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0078","description":"Injection_ fosphenytoin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Io anal gast n-stim subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95981","description":"Io anal gast n-stim subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA0","description":"ICD-BIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hernia repair preemie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83651","description":"Anesth hernia repair preemie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED1","description":"ICD-GHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC1","description":"ICD-FFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"General Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4007","description":"General Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE1","description":"ICD-OEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270U","description":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE221","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB33","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1010T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","description":"CPT-1010T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF1","description":"ICD-KFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2789","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2789","description":"HCPCS-J2789","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Platelet Function Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0277U","description":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Platelet Function Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5523","description":"Hip midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE0","description":"ICD-KIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC0","description":"ICD-NKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk pn xm on init visit date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2040F","description":"Bk pn xm on init visit date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD0","description":"ICD-OJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC1","description":"ICD-CAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optical endomicroscpy interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88375","description":"Optical endomicroscpy interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA1","description":"ICD-MABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0871","description":"HCPCS-J0871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC1","description":"ICD-CICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA1","description":"ICD-NHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42955","description":"Surgical opening of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert/place heart catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93503","description":"Insert/place heart catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99327","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43045","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC0","description":"ICD-FEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD0","description":"ICD-OCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD1","description":"ICD-MFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","description":"CPT-00866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99212","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF1","description":"ICD-GFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA1","description":"ICD-KATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1000F","description":"Tobacco use assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB41","description":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL11","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/nonauto graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35883","description":"Revise graft w/nonauto graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA1","description":"ICD-NIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam k transpl w/doppler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76776","description":"Us exam k transpl w/doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD1","description":"ICD-GFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE0","description":"ICD-GDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Persistent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1038F","description":"Persistent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB104","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC1","description":"ICD-GEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rocking bed w/ or w/o side r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0462","description":"Rocking bed w/ or w/o side r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow harvest autolog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38232","description":"Bone marrow harvest autolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity class severe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1493F","description":"Dem severity class severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD105","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED1","description":"ICD-OIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF1","description":"ICD-GGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52300","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC1","description":"ICD-OEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC0","description":"ICD-CFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB0","description":"ICD-PLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF1","description":"ICD-OLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB1","description":"ICD-GDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF0","description":"ICD-EEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal application device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7034","description":"Nasal application device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA1","description":"ICD-JDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC0","description":"ICD-NEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA1","description":"ICD-KEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF0","description":"ICD-CHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF1","description":"ICD-OIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF0","description":"ICD-IIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place breast rad tube/caths","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19298","description":"Place breast rad tube/caths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB0","description":"ICD-BGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69725","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA1","description":"ICD-PDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting body mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7945","description":"Bone cutting body mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE0","description":"ICD-CIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD1","description":"ICD-OLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rasburicase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2783","description":"Rasburicase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD0","description":"ICD-IAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9775","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD0","description":"ICD-NHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD0","description":"ICD-NHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA0","description":"ICD-OEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Truss addition to std pad wa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8320","description":"Truss addition to std pad wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC0","description":"ICD-ICHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD0","description":"ICD-CHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE0","description":"ICD-OKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Loop heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0951","description":"Loop heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","description":"HCPCS-Q4435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary bladder retention","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78730","description":"Urinary bladder retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation arm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20802","description":"Replantation arm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD1","description":"ICD-FCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA1","description":"ICD-GEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD0","description":"ICD-JGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebound matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4296","description":"Rebound matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj anesthetic per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4737","description":"Inj anesthetic per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF1","description":"ICD-KHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC1","description":"ICD-CFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thoracic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38746","description":"Remove thoracic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX11","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD0","description":"ICD-AAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (ANI)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0802","description":"Injection_ corticotropin (ANI)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA0","description":"ICD-AALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF0","description":"ICD-CBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC1","description":"ICD-CIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bp out of nrml limits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9274","description":"Bp out of nrml limits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE1","description":"ICD-OFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA1","description":"ICD-GIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD1","description":"ICD-GEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref pulm fx test/peakflow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3758F","description":"Pt ref pulm fx test/peakflow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE0","description":"ICD-NEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No reas_ no ret or w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9515","description":"No reas_ no ret or w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0949T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","description":"CPT-0949T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME0","description":"ICD-FEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gs mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9237","description":"Gs mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8762","description":"Pd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42182","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC0","description":"ICD-NHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC1","description":"ICD-IBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5245","description":"Hearing aid_ prog_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD0","description":"ICD-MGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad pump ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33981","description":"Replace vad pump ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9744","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9821","description":"No documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42507","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nushield 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4160","description":"Nushield 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA0","description":"ICD-GDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA21","description":"ICD-3FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD1","description":"ICD-JFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5362","description":"Speech screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-52443","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","description":"CPT-52443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron hcl 1 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0166","description":"Granisetron hcl 1 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43361","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1333","description":"Acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF1","description":"ICD-OETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA1","description":"ICD-OCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE1","description":"ICD-MATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF1","description":"ICD-OJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF1","description":"ICD-AAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE1","description":"ICD-KHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA0","description":"ICD-BEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE0","description":"ICD-IGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC0","description":"ICD-IAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68115","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA0","description":"ICD-GFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33019","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25360","description":"Revision of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD0","description":"ICD-PHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB0","description":"ICD-CHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise knuckle with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26531","description":"Revise knuckle with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB1","description":"ICD-MGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB1","description":"ICD-GDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88237","description":"Tissue culture bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE0","description":"ICD-JCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4020","description":"Ophthalmology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE0","description":"ICD-FDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE1","description":"ICD-KDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE0","description":"ICD-IHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF0","description":"ICD-MLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0879","description":"Pwc gp4 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581T","description":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC0","description":"ICD-OGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90690","description":"Typhoid vaccine oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD1","description":"ICD-ABCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6206","description":"Contact layer <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","description":"HCPCS-J0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1921","description":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF0","description":"ICD-JBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF1","description":"ICD-OCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF0","description":"ICD-FBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE0","description":"ICD-ODPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5812","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD0","description":"ICD-NKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA0","description":"ICD-GGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diaper serv reusable diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4538","description":"Diaper serv reusable diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65710","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA0","description":"ICD-KIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1117","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","description":"CPT-76017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA0","description":"ICD-CIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD1","description":"ICD-MKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calcitonin stimul panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80410","description":"Calcitonin stimul panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB0","description":"ICD-FHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1257","description":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE1","description":"ICD-KASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27606","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High risk recurrence pro ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8465","description":"High risk recurrence pro ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC0","description":"ICD-FHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB141","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE1","description":"ICD-OFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB0","description":"ICD-IFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22846","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked/cnsld aed effects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6070F","description":"Pt asked/cnsld aed effects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50949","description":"Laparoscope proc ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB0","description":"ICD-JAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC217","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inter active grp psych parti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0411","description":"Inter active grp psych parti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB1","description":"ICD-KDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA10","description":"High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF0","description":"ICD-MFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD0","description":"ICD-ICLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA1","description":"ICD-AHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA136","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low density lipoprotein(ldl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2120","description":"Low density lipoprotein(ldl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA0","description":"ICD-ODXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD0","description":"ICD-KFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4528","description":"Adult size pull-on xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC1","description":"ICD-OBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA0","description":"ICD-CEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA0","description":"ICD-HDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB0","description":"ICD-CIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vaccine adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90632","description":"Hepa vaccine adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of arm artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35045","description":"Repair defect of arm artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB0","description":"ICD-LAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35184","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093U","description":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace tissue expander","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11970","description":"Replace tissue expander","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA0","description":"ICD-GCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl water chamber_ pap dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7046","description":"Repl water chamber_ pap dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/computer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95953","description":"Eeg monitoring/computer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA1","description":"ICD-DAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF1","description":"ICD-OKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD0","description":"ICD-ACMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD1","description":"ICD-OCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch urine w barrier/tapv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4431","description":"Ost pch urine w barrier/tapv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC60","description":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pouch drainable w barrier at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5061","description":"Pouch drainable w barrier at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37242","description":"Vasc embolize/occlude artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21454","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fludarabine phosphate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9185","description":"Fludarabine phosphate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51841","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneuma compresor non-segment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0650","description":"Pneuma compresor non-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4381","description":"Urinary plastic pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1703","description":"HCPCS-B1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF0","description":"ICD-PBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99253","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE0","description":"ICD-KACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF0","description":"ICD-NKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD0","description":"ICD-BDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB31","description":"ICD-4IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodobenguate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9508","description":"I131 iodobenguate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home infusion each addtl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99602","description":"Home infusion each addtl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxymorphone hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2410","description":"Oxymorphone hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA0","description":"ICD-EEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME0","description":"ICD-NDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue in-situ hybridization","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0479","description":"Tissue in-situ hybridization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5995","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB0","description":"ICD-EATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl 5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0161","description":"Chlorpromazine hcl 5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA1","description":"ICD-DIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF0","description":"ICD-EFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1931","description":"Laronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay quant nos nonab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83520","description":"Immunoassay quant nos nonab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0528","description":"HCPCS-J0528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF1","description":"ICD-EBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD0","description":"ICD-OKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj ocular telescope prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308T","description":"Insj ocular telescope prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF1","description":"ICD-BBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD1","description":"ICD-FBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC1","description":"ICD-CGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9166","description":"Injection_ secukinumab_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB0","description":"ICD-JFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE0","description":"ICD-MFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE205","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB1","description":"ICD-NIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC1","description":"ICD-IIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA1","description":"ICD-KEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA1","description":"ICD-ACCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE1","description":"ICD-FAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immed man part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5222","description":"Immed man part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Missed appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9986","description":"Missed appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","description":"HCPCS-Q4440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diag laparo separate proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49320","description":"Diag laparo separate proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation foot complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20838","description":"Replantation foot complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC0","description":"ICD-EHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","description":"CPT-00402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9348","description":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3252","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99177","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioTX_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4324","description":"AmnioTX_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD1","description":"ICD-JIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD0","description":"ICD-KAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tissue of origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81504","description":"Oncology tissue of origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB1","description":"ICD-BFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8920","description":"Mra w/o fol w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asp not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9436","description":"Asp not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC1","description":"ICD-OIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD1","description":"ICD-KEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA0","description":"ICD-AEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD0","description":"ICD-JAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB1","description":"ICD-FGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam infant hips dynamic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76885","description":"Us exam infant hips dynamic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB0","description":"ICD-KCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD1","description":"ICD-KHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB114","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDerm C_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2018","description":"PermeaDerm C_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No photodoc cecal ldmk exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9614","description":"No photodoc cecal ldmk exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0519","description":"HCPCS-Q0519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC0","description":"ICD-NBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE1","description":"ICD-NHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Miroderm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4175","description":"Miroderm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND1","description":"ICD-NHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD1","description":"ICD-OBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD0","description":"ICD-ADUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB0","description":"ICD-GCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME1","description":"ICD-JFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC0","description":"ICD-OFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irinotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9206","description":"Irinotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE0","description":"ICD-OKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE0","description":"ICD-MCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD0","description":"ICD-JBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of angiotensin ii","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82163","description":"Assay of angiotensin ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE1","description":"ICD-LFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD0","description":"ICD-JDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44650","description":"Repair bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB11","description":"ICD-1IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE0","description":"ICD-OICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41872","description":"Repair gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB1","description":"ICD-CCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0693T","description":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recement space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1550","description":"Recement space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9879","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90962","description":"Esrd serv 1 visit p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD1","description":"ICD-KAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB0","description":"ICD-NCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC0","description":"ICD-JETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA0","description":"ICD-EDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF0","description":"ICD-CBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE0","description":"ICD-JHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE0","description":"ICD-BGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92508","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92242","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2029","description":"Sex offend tx svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE0","description":"ICD-EIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD1","description":"ICD-FEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE0","description":"ICD-OEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE0","description":"ICD-JGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glassia injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0257","description":"Glassia injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Padding for comprssn bdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8430","description":"Padding for comprssn bdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA0","description":"ICD-JIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hpv types 16 & 18 only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87625","description":"Hpv types 16 & 18 only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB11","description":"ICD-1LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8G","description":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD1","description":"ICD-OLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0833T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tenecteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3101","description":"Tenecteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD1","description":"ICD-BGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9176","description":"Injection_ elotuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE0","description":"ICD-GDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE1","description":"ICD-CELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2132","description":"Kafo femoral fx cast soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Etanercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1438","description":"Etanercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF0","description":"ICD-PIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE1","description":"ICD-KGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB0","description":"ICD-BBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9295","description":"Injection_ necitumumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA15","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB0","description":"ICD-CFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA0","description":"ICD-CASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB1","description":"ICD-EEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF0","description":"ICD-GHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB1","description":"ICD-BBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC1","description":"ICD-OFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB1","description":"ICD-OJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA1","description":"ICD-GAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD1","description":"ICD-GEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND0","description":"ICD-NHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5C","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01941","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","description":"CPT-01941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB1","description":"ICD-HBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75831","description":"Vein x-ray kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES336","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD1","description":"ICD-MBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC1","description":"ICD-NAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0238","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","description":"HCPCS-M0238","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB0","description":"ICD-OBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB0","description":"ICD-NGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD1","description":"ICD-NDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB0","description":"ICD-FETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43755","description":"Dx gastr intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD1","description":"ICD-ACAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE1","description":"ICD-NEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneum int legs/trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0670","description":"Seg pneum int legs/trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43108","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood transfusion service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36430","description":"Blood transfusion service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Child fostercare th per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5145","description":"Child fostercare th per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB1","description":"ICD-OBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB225","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental cephalometric film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0340","description":"Dental cephalometric film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB1","description":"ICD-KGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF0","description":"ICD-KAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD0","description":"ICD-CGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL24","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB0","description":"ICD-HAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF0","description":"ICD-GIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF0","description":"ICD-GDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB1","description":"ICD-BILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cross-over vein graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34520","description":"Cross-over vein graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bactericidal level serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87197","description":"Bactericidal level serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES131","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 74-100 gm pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4197","description":"Parenteral sol 74-100 gm pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE212","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB0","description":"ICD-ADEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB21","description":"ICD-2FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC1","description":"ICD-EBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD1","description":"ICD-BEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q4h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9504","description":"Hit antibiotic q4h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9736","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC0","description":"ICD-NANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp lithotripsy calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43265","description":"Ercp lithotripsy calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB0","description":"ICD-FIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF0","description":"ICD-MBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise oral mucosa for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40818","description":"Excise oral mucosa for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC101","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr cbl combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0493","description":"Emr pwr cbl combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF1","description":"ICD-CFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11440","description":"Exc face-mm b9+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of forearm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29075","description":"Application of forearm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA0","description":"ICD-FCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68420","description":"Incise/drain tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sutures same surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15850","description":"Remove sutures same surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9030","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6583","description":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB0","description":"ICD-HHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert palate implants","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9727","description":"Insert palate implants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE1","description":"ICD-ECEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE0","description":"ICD-GEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1738","description":"HCPCS-C1738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB0","description":"ICD-AHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enclosed ped crib hosp grade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0300","description":"Enclosed ped crib hosp grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation patient unable to communicate and informant not available","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2183","description":"Documentation patient unable to communicate and informant not available","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD1","description":"ICD-CECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF1","description":"ICD-FIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE1","description":"ICD-GGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA1","description":"ICD-FCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF1","description":"ICD-KDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF1","description":"ICD-IIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC0","description":"ICD-KHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scratch resistant coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2760","description":"Scratch resistant coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","description":"HCPCS-A4479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC1","description":"ICD-NDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD1","description":"ICD-HDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031U","description":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB1","description":"ICD-MKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt talk psychsoc&rx oh dpnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4320F","description":"Pt talk psychsoc&rx oh dpnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD0","description":"ICD-CAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF1","description":"ICD-FBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB1","description":"ICD-IEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC21","description":"ICD-1HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB1","description":"ICD-PAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1464","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","description":"HCPCS-M1464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobilize erupted/malpos toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7282","description":"Mobilize erupted/malpos toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB224","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB1","description":"ICD-NDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit chelation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9355","description":"Hit chelation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB0","description":"ICD-GBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86834","description":"Hla class i semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD0","description":"ICD-CBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93788","description":"Ambulatory bp analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air elevator for heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0370","description":"Air elevator for heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breast pump bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4285","description":"Replcmnt breast pump bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE1","description":"ICD-GGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE1","description":"ICD-JITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB1","description":"ICD-BBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD0","description":"ICD-OKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB1","description":"ICD-ECCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD1","description":"ICD-OEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion 13/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22804","description":"Post fusion 13/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c revrs trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87522","description":"Hepatitis c revrs trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE0","description":"ICD-GHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD1","description":"ICD-BAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"American amnion ac tri-layer_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4305","description":"American amnion ac tri-layer_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral prescrip drug non chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8499","description":"Oral prescrip drug non chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove esophagus obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74235","description":"Remove esophagus obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99412","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD1","description":"ICD-KELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna vrl ldnot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21936","description":"Resect back tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6603","description":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pvc intravenous administ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1016","description":"Non-pvc intravenous administ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","description":"HCPCS-M1409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB1","description":"ICD-MKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME1","description":"ICD-FGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF0","description":"ICD-EBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND1","description":"ICD-FHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF1","description":"ICD-GABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2184","description":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD1","description":"ICD-KHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta-2 glycoprotein antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86146","description":"Beta-2 glycoprotein antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC0","description":"ICD-GBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF1","description":"ICD-NFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC0","description":"ICD-MKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE1","description":"ICD-BEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC1","description":"ICD-DHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE0","description":"ICD-GBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF1","description":"ICD-CAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No tob assess or cess inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9460","description":"No tob assess or cess inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2040","description":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE1","description":"ICD-GFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC0","description":"ICD-BCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"G6pc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81250","description":"G6pc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA1","description":"ICD-JACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB1","description":"ICD-OKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9772","description":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC0","description":"ICD-KAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4596","description":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27823","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6195","description":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF1","description":"ICD-LIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88014","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE235","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC1","description":"ICD-GHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE0","description":"ICD-CFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD0","description":"ICD-KDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD1","description":"ICD-GCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE0","description":"ICD-NGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD0","description":"ICD-KDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL25","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC24","description":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA46","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE0","description":"ICD-FDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7204","description":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4500","description":"Below knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB0","description":"ICD-OCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB0","description":"ICD-LGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj paracervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64435","description":"N block inj paracervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67450","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD0","description":"ICD-OJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC1","description":"ICD-DFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA0","description":"ICD-ABUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE0","description":"ICD-EFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE220","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA1","description":"ICD-GIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7534","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB1","description":"ICD-NAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD0","description":"ICD-PBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8678","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap es sph augment dev place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392T","description":"Lap es sph augment dev place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME1","description":"ICD-CIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repr per/vag pouch dbl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46712","description":"Repr per/vag pouch dbl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Superimposed prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5954","description":"Superimposed prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5128","description":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA1","description":"ICD-IGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA0","description":"ICD-IBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB0","description":"ICD-GDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD1","description":"ICD-LIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF1","description":"ICD-NGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28160","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Basic support routine suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0382","description":"Basic support routine suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1626","description":"Granisetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24071","description":"Exc arm/elbow les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No knee joint with artic ali","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5220","description":"No knee joint with artic ali","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE1","description":"ICD-NCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME0","description":"ICD-BDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2C","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9408","description":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","description":"CPT-00524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anorectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45108","description":"Removal of anorectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE1","description":"ICD-NEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB0","description":"ICD-KIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF1","description":"ICD-OCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6087","description":"Implant Supported Crown - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC1","description":"ICD-HBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX32","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE1","description":"ICD-FFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC1","description":"ICD-JBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD1","description":"ICD-OAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61880","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oscillating tracking test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92545","description":"Oscillating tracking test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip core decompression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2325","description":"Hip core decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE1","description":"ICD-GAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC0","description":"ICD-NEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC0","description":"ICD-GIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD0","description":"ICD-JEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1041T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1041T","description":"CPT-1041T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD1","description":"ICD-LEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","description":"CPT-00320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC0","description":"ICD-NGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked re symp auto dysfxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4326F","description":"Pt asked re symp auto dysfxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA1","description":"ICD-HAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF0","description":"ICD-OHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","description":"HCPCS-J1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein access cutdown < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36420","description":"Vein access cutdown < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27556","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF1","description":"ICD-FAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polysom <6 yrs 4/> paramtrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95782","description":"Polysom <6 yrs 4/> paramtrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1297","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB0","description":"ICD-NFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE140","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD0","description":"ICD-GBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB1","description":"ICD-ABCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA1","description":"ICD-HAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty_ medialization_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31591","description":"Laryngoplasty_ medialization_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF0","description":"ICD-ABEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9274","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376U","description":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22844","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE0","description":"ICD-GBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID1","description":"ICD-NFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low frequency non-thermal us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97610","description":"Low frequency non-thermal us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m maa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9540","description":"Tc99m maa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA1","description":"ICD-GEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","description":"CPT-00470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84251","description":"Anesth amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD0","description":"ICD-JAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemiluminescent assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82397","description":"Chemiluminescent assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF0","description":"ICD-NGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36568","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB1","description":"ICD-KBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home modifications per serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5165","description":"Home modifications per serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE0","description":"ICD-GHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF0","description":"ICD-CELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tprnl Plmt Biodegradable Matrl Periprostatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438T","description":"Tprnl Plmt Biodegradable Matrl Periprostatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8G","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2782","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9797","description":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA0","description":"ICD-OGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abduct rotation bar w/o shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3150","description":"Abduct rotation bar w/o shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove&replace pm gen singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33227","description":"Remove&replace pm gen singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg <= 16 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0744","description":"Absorp drg <= 16 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD1","description":"ICD-OIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB1","description":"ICD-ECMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA1","description":"ICD-CHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB1","description":"ICD-NHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"A/d tx program_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2035","description":"A/d tx program_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1089","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE0","description":"ICD-HIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE113","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE1","description":"ICD-OCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73219","description":"MRI upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF0","description":"ICD-GBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA1","description":"ICD-GATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0063U","description":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA0","description":"ICD-KGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit longterm infusion diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9347","description":"Hit longterm infusion diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB0","description":"ICD-DCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA0","description":"ICD-PHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1135","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF0","description":"ICD-OEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC0","description":"ICD-IGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99221","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA0","description":"ICD-JBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0602","description":"HCPCS-C0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1B","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78599","description":"Respiratory nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of quinidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80194","description":"Assay of quinidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1526","description":"Space maintainer_ removable bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC42","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA0","description":"ICD-CIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB0","description":"ICD-NFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB31","description":"ICD-4FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF1","description":"ICD-GIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75756","description":"Artery x-rays chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD1","description":"ICD-NIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC0","description":"ICD-OHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE1","description":"ICD-IGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA1","description":"ICD-ADAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC1","description":"ICD-BBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33600","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE0","description":"ICD-GADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB0","description":"ICD-KHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye mvmt alys w/o calbrj i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0615T","description":"Eye mvmt alys w/o calbrj i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE0","description":"ICD-JFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58400","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF1","description":"ICD-KDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 25-99","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88274","description":"Cytogenetics 25-99","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration; with imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10022","description":"Fine needle aspiration; with imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA1","description":"ICD-PFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD1","description":"ICD-CCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilio-celiac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35632","description":"Art byp ilio-celiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6582","description":"Gradient compression gauntlet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy by infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0084","description":"Chemotherapy by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4024","description":"Cast sup sht arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharm rx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9699","description":"Radiopharm rx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm <=149 mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9958","description":"Hocm <=149 mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0640","description":"Lso s/c shell/panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB35","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF1","description":"ICD-MJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore abdominal vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35840","description":"Explore abdominal vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC0","description":"ICD-CDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB1","description":"ICD-ABDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA24","description":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB1","description":"ICD-IHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE0","description":"ICD-HCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD0","description":"ICD-FBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump adpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4282","description":"Replacement breastpump adpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB0","description":"ICD-OHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE0","description":"ICD-BCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD0","description":"ICD-MCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD1","description":"ICD-KFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6572","description":"Gradient compression garment_ toe caps_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8I","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF1","description":"ICD-EDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE0","description":"ICD-AEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg vein fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34530","description":"Leg vein fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA145","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF1","description":"ICD-NADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD0","description":"ICD-JHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA1","description":"ICD-OBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86021","description":"Wbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","description":"HCPCS-J1163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA0","description":"ICD-NJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD0","description":"ICD-GBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF1","description":"ICD-GIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC0","description":"ICD-HIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33310","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA1","description":"ICD-KCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25909","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB0","description":"ICD-CIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB1","description":"ICD-NBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00862","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","description":"CPT-00862","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68510","description":"Biopsy of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE1","description":"ICD-GICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72128","description":"Ct chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place device/marker_ non pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9728","description":"Place device/marker_ non pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1081T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1081T","description":"CPT-1081T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine nrv >2 segmnts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63190","description":"Incise spine nrv >2 segmnts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0477T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1154","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76516","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF0","description":"ICD-CAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microvolt t-wave assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93025","description":"Microvolt t-wave assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C-reactive protein hs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86141","description":"C-reactive protein hs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55831","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric suction pump hme mdl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2000","description":"Gastric suction pump hme mdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27280","description":"Fusion of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA0","description":"ICD-CGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77048","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE0","description":"ICD-FIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF1","description":"ICD-NJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA11","description":"ICD-1JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA1","description":"ICD-MGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF1","description":"ICD-PLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical dress holder reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4463","description":"Surgical dress holder reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD236","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed write/oral pts w/ hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4003F","description":"Pt ed write/oral pts w/ hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2070","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB1","description":"ICD-HGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD1","description":"ICD-GCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA1","description":"ICD-JAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA51","description":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB0","description":"ICD-CIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","description":"HCPCS-M1390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert mesh/pelvic flr addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57267","description":"Insert mesh/pelvic flr addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50750","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF1","description":"ICD-OCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL33","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syme typ expandabl wall sckt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5630","description":"Syme typ expandabl wall sckt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE1","description":"ICD-MHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC0","description":"ICD-MKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB1","description":"ICD-CIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD0","description":"ICD-FDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90281","description":"Human ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC0","description":"ICD-CGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26499","description":"Revision of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA0","description":"ICD-KAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58943","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED1","description":"ICD-OKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1954","description":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","description":"HCPCS-J9341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE1","description":"ICD-DCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD1","description":"ICD-EBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mediskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4135","description":"Mediskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44366","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD0","description":"ICD-GCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96164","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC0","description":"ICD-AGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9739","description":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD0","description":"ICD-NJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90623","description":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29130","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF1","description":"ICD-CDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD0","description":"ICD-BGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mesentery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44850","description":"Repair of mesentery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq transcath closure pda","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93582","description":"Perq transcath closure pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE1","description":"ICD-NEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF1","description":"ICD-EITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB1","description":"ICD-EBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF1","description":"ICD-CIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89352","description":"Thawing cryopresrved embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 2 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95131","description":"Immntx 2 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove radius bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24136","description":"Remove radius bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA1","description":"ICD-BBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE0","description":"ICD-GARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC1","description":"ICD-FEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB0","description":"ICD-CADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0005","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD0","description":"ICD-GHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD1","description":"ICD-AIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD0","description":"ICD-KGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE1","description":"ICD-IEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis a antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86708","description":"Hepatitis a antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED1","description":"ICD-IAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0139U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of transcortin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84449","description":"Assay of transcortin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36512","description":"Apheresis rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Yellow fever vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90717","description":"Yellow fever vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9210","description":"Injection_ emapalumab-lzsg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad exc lesion up to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7410","description":"Rad exc lesion up to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oct breast surg cavity i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354T","description":"Oct breast surg cavity i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE0","description":"ICD-PFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symes ankle w/o (sach) foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5703","description":"Symes ankle w/o (sach) foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67218","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB1","description":"ICD-FILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1A","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA0","description":"ICD-MLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE1","description":"ICD-DGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB1","description":"ICD-NGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD1","description":"ICD-ODYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB21","description":"ICD-1BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA1","description":"ICD-EATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xray control catheter change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75984","description":"Xray control catheter change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise ileoanal reservior","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45136","description":"Excise ileoanal reservior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC0","description":"ICD-ODRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA0","description":"ICD-OKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA0","description":"ICD-MJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guardant360 CDX_ Guardant Health Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0242U","description":"Guardant360 CDX_ Guardant Health Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0888T","description":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion ther other than che","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0081","description":"Infusion ther other than che","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB0","description":"ICD-MGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF1","description":"ICD-FFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63273","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE0","description":"ICD-LFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF0","description":"ICD-JBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE1","description":"ICD-BIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD1","description":"ICD-ECHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alveolus open reduction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7671","description":"Alveolus open reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE0","description":"ICD-MKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB0","description":"ICD-FGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE0","description":"ICD-FGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC1","description":"ICD-GATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9365","description":"1high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4C","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","description":"HCPCS-M1458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84580","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84181","description":"Western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF1","description":"ICD-ODIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB21","description":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA0","description":"ICD-OISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound(s) care non-selective","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97602","description":"Wound(s) care non-selective","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11601","description":"Exc tr-ext mal+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC1","description":"ICD-KAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF0","description":"ICD-OJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy disc reposit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7874","description":"Tmj arthroscopy disc reposit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD1","description":"ICD-EILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF0","description":"ICD-FBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB1","description":"ICD-MHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA216","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20703","description":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fludeoxyglucose f18 up to 15 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9609","description":"Fludeoxyglucose f18 up to 15 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9732","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC0","description":"ICD-PLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50553","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD0","description":"ICD-GGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE1","description":"ICD-NLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Refract not +/- 1.0 w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9520","description":"Refract not +/- 1.0 w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD1","description":"ICD-BCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray skull epidural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75872","description":"Vein x-ray skull epidural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD1","description":"ICD-PKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusive device in vein art","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0269","description":"Occlusive device in vein art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","description":"HCPCS-J2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF0","description":"ICD-NJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47380","description":"Open ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63272","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt heart pm atrial & vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33208","description":"Insrt heart pm atrial & vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide intestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74355","description":"X-ray guide intestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF1","description":"ICD-CEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anl sp inf pmp w/mdreprg&fil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62370","description":"Anl sp inf pmp w/mdreprg&fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syph scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3512F","description":"Syph scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF1","description":"ICD-BALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91305","description":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA31","description":"ICD-3BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD1","description":"ICD-HFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD0","description":"ICD-BCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9757","description":"Laminotomy (Hemilaminectomy)_ With Decompression Of Nerve Root(S)_ Including Partial Facetectomy_ Foraminotomy And Excision Of Herniated Intervertebral Disc_ And Repair Of Ann","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90968","description":"Esrd home pt srv p day 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB1","description":"ICD-PFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"<50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1008","description":"<50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap colectomy w/proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44211","description":"Lap colectomy w/proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0994T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","description":"CPT-0994T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above knee manual lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5925","description":"Above knee manual lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB0","description":"ICD-FDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mast simple complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19303","description":"Mast simple complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB1","description":"ICD-DDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contour cranial bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21181","description":"Contour cranial bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81522","description":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swg/sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5828","description":"Endo knee-shin fluid swg/sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC1","description":"ICD-CFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove infected skull bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61501","description":"Remove infected skull bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE0","description":"ICD-GAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE0","description":"ICD-KEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF0","description":"ICD-CBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX14","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19271","description":"Revision of chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare fecal microbiota","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44705","description":"Prepare fecal microbiota","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA0","description":"ICD-OJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF0","description":"ICD-BILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB11","description":"ICD-1AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF1","description":"ICD-FDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD1","description":"ICD-OKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC0","description":"ICD-GIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46070","description":"Incision of anal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1476","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","description":"HCPCS-M1476","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjustable angle footplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0040","description":"Adjustable angle footplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC1","description":"ICD-JFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26535","description":"Revise finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC1","description":"ICD-OIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF1","description":"ICD-BFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5166","description":"HCPCS-Q5166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49621","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meas lung vol thru 2 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94013","description":"Meas lung vol thru 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AstraZeneca COVID-19 vaccine administration — second dose","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1706","description":"AstraZeneca COVID-19 vaccine administration — second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF1","description":"ICD-PCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA1","description":"ICD-LARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA0","description":"ICD-JDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy w/o taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44126","description":"Enterectomy w/o taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF0","description":"ICD-FHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB0","description":"ICD-PGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy lymph node exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32674","description":"Thoracoscopy lymph node exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB0","description":"ICD-KFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB1","description":"ICD-NIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43635","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA0","description":"ICD-AICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD1","description":"ICD-NGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Front caster assem complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0077","description":"Front caster assem complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD1","description":"ICD-CHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF1","description":"ICD-GIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31291","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiof trsmtr implt scrl neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8684","description":"Radiof trsmtr implt scrl neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66225","description":"Repair/graft eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE1","description":"ICD-CDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID0","description":"ICD-IHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD235","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB1","description":"ICD-JHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB1","description":"ICD-NJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for non-ESRD use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0883","description":"Injection_ argatroban_ 1 mg (for non-ESRD use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF1","description":"ICD-FFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB1","description":"ICD-OCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB25","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB1","description":"ICD-GHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF1","description":"ICD-KGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1027","description":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA0","description":"ICD-CDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF0","description":"ICD-BGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA0","description":"ICD-GFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB0","description":"ICD-GHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90386","description":"Rh ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture bacterial urine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P7001","description":"Culture bacterial urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF0","description":"ICD-HCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF1","description":"ICD-BGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF0","description":"ICD-CIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB0","description":"ICD-CBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1823","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","description":"HCPCS-E1823","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD1","description":"ICD-CBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC1","description":"ICD-GGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD1","description":"ICD-ABMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9171","description":"HCPCS-C9171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC0","description":"ICD-GCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2158","description":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eltrd/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33243","description":"Remove eltrd/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388U","description":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth w/o gen/neurax anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4560F","description":"Anesth w/o gen/neurax anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blastomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86612","description":"Blastomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA0","description":"ICD-DHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5104","description":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC0","description":"ICD-CEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9373","description":"Hit hydra total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB0","description":"ICD-OCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB1","description":"ICD-IHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2208","description":"Lens sphcy bifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37228","description":"Tib/per revasc w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD1","description":"ICD-BDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF0","description":"ICD-OCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43641","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB1","description":"ICD-DGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment leotard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6510","description":"Compres burn garment leotard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB0","description":"ICD-GHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE0","description":"ICD-FFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for myelogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62284","description":"Injection for myelogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML42","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF1","description":"ICD-BDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB1","description":"ICD-BGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolloid drg filler dry","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6241","description":"Hydrocolloid drg filler dry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF1","description":"ICD-AHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA0","description":"ICD-CELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC1","description":"ICD-CBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE0","description":"ICD-CCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE0","description":"ICD-NIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD0","description":"ICD-JAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA224","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD0","description":"ICD-KGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA31","description":"ICD-4CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF1","description":"ICD-KDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB1","description":"ICD-OLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF0","description":"ICD-OJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary suspensory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5105","description":"Urinary suspensory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB1","description":"ICD-OJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81182","description":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC0","description":"ICD-EFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA0","description":"ICD-GFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA0","description":"ICD-AFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE0","description":"ICD-GDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF0","description":"ICD-GFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB46","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0036U","description":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD0","description":"ICD-JETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE0","description":"ICD-NEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37264","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","description":"CPT-37264","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE1","description":"ICD-NFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ipratropium bromide comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7645","description":"Ipratropium bromide comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD1","description":"ICD-FIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33320","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA1","description":"ICD-HCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD1","description":"ICD-NHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF1","description":"ICD-CADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC1","description":"ICD-DBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED1","description":"ICD-AIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable male external cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4349","description":"Disposable male external cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF1","description":"ICD-JICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 7.12-20","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2302","description":"Lens sphere trifocal 7.12-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90477","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61559","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of hymen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56700","description":"Partial removal of hymen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2204","description":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX51","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15950","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33420","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA1","description":"ICD-DGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8396","description":"Lvef not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analyze spine infus pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62367","description":"Analyze spine infus pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93971","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound breast complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76641","description":"Ultrasound breast complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD1","description":"ICD-MCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC0","description":"ICD-NCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26951","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF0","description":"ICD-GCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB1","description":"ICD-OJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0554T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF1","description":"ICD-MLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD0","description":"ICD-BIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remov vertbr dcmprn thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63087","description":"Remov vertbr dcmprn thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME1","description":"ICD-IHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA1","description":"ICD-OKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE1","description":"ICD-NLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB1","description":"ICD-HEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6448","description":"Lt compres band <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6599","description":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB0","description":"ICD-BGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC0","description":"ICD-PJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12041","description":"Intmd rpr n-hf/genit 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF1","description":"ICD-IHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD0","description":"ICD-JIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0589U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","description":"CPT-0589U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC0","description":"ICD-BAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF1","description":"ICD-JDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD0","description":"ICD-BDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC1","description":"ICD-IDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA1","description":"ICD-DISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE0","description":"ICD-FFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/.25-2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2111","description":"Spherocylindr 7.25d/.25-2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4365","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","description":"HCPCS-Q4365","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25230","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alt long-term cntrl med rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4144F","description":"Alt long-term cntrl med rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF1","description":"ICD-IEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8578","description":"No reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC1","description":"ICD-JEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB0","description":"ICD-GAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB0","description":"ICD-CAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC0","description":"ICD-AICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD0","description":"ICD-NEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC0","description":"ICD-LCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC21","description":"ICD-2AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD0","description":"ICD-JFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB0","description":"ICD-MCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Itraconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80189","description":"Itraconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF0","description":"ICD-ICDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA0","description":"ICD-HIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC0","description":"ICD-OBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wedge biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47100","description":"Wedge biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD1","description":"ICD-KGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31750","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61524","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB117","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35112","description":"Repair artery rupture spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67921","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2308","description":"Lens sphc trifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE1","description":"ICD-OGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft splenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35536","description":"Art byp grft splenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB1","description":"ICD-CCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF0","description":"ICD-CGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB0","description":"ICD-KIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD0","description":"ICD-DIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF1","description":"ICD-BIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not disch to home day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8825","description":"Pt not disch to home day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC60","description":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj cmo not pres rsn not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8929","description":"Adj cmo not pres rsn not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86813","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD1","description":"ICD-NCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA1","description":"ICD-GDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33963","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE1","description":"ICD-LBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC0","description":"ICD-BDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA0","description":"ICD-NITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0601","description":"HCPCS-B0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB0","description":"ICD-CIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD1","description":"ICD-JBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF0","description":"ICD-AICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac after care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59622","description":"Attempted vbac after care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE0","description":"ICD-NIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8701","description":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9119","description":"Injection_ cemiplimab-rwlc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF1","description":"ICD-KFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF0","description":"ICD-GGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5983","description":"Radiation applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB104","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76883","description":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86702","description":"Hiv-2 antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD1","description":"ICD-EHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF0","description":"ICD-AGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF0","description":"ICD-JDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0530T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33322","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in ltch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5007","description":"Hospice in ltch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5116","description":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0406","description":"Inpt/tele follow up 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB0","description":"ICD-NDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA60","description":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0534","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","description":"HCPCS-G0534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD1","description":"ICD-LBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA50","description":"Low Rehab_ ADL Index 0-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA1","description":"ICD-PBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1101T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1101T","description":"CPT-1101T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD0","description":"ICD-HFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE0","description":"ICD-CBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD1","description":"ICD-GAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj streptokinase /250000 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2995","description":"Inj streptokinase /250000 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9439","description":"P2y inhib not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF1","description":"ICD-JITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topical prep rx aoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4130F","description":"Topical prep rx aoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC0","description":"ICD-PBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE0","description":"ICD-IDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35303","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF1","description":"ICD-OKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx med space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32606","description":"Thoracoscopy w/bx med space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33762","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD1","description":"ICD-LHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF0","description":"ICD-FHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE0","description":"ICD-DCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76706","description":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF1","description":"ICD-GDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE1","description":"ICD-AFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Francisella tularensis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86668","description":"Francisella tularensis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","description":"CPT-00620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","description":"HCPCS-L6034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB1","description":"ICD-GEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE0","description":"ICD-OEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4042","description":"Cast sup lng leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA1","description":"ICD-GIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC0","description":"ICD-MDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trastuzumab not administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9837","description":"Trastuzumab not administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF1","description":"ICD-NENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA1","description":"ICD-NCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE235","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467U","description":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5C","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF1","description":"ICD-NEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86409","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB1","description":"ICD-GICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD0","description":"ICD-CEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA1","description":"ICD-IEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9725","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC1","description":"ICD-AILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF0","description":"ICD-KBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA0","description":"ICD-JGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA14","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD105","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA0","description":"ICD-FGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BCG live intravesical instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9030","description":"BCG live intravesical instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE0","description":"ICD-BIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC0","description":"ICD-FIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF1","description":"ICD-CIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC1","description":"ICD-HBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","description":"HCPCS-J0609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB1","description":"ICD-EAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML05","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC11","description":"ICD-3AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF0","description":"ICD-JGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct gas permeable sphericl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2510","description":"Cntct gas permeable sphericl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA0","description":"ICD-NFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB0","description":"ICD-NKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0993T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","description":"CPT-0993T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5124","description":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9058","description":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7209","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26426","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/subs interv 15-30mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0396","description":"Alcohol/subs interv 15-30mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc cryo ablate renal tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50593","description":"Perc cryo ablate renal tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6557","description":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mast radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19305","description":"Mast radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC1","description":"ICD-MLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electro connect btw 2 sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2311","description":"Electro connect btw 2 sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruct b9 lesion 1-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17110","description":"Destruct b9 lesion 1-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0616","description":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB0","description":"ICD-OBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"History aids-defining cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3490F","description":"History aids-defining cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advancing cancer care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0001","description":"Advancing cancer care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE0","description":"ICD-OACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC0","description":"ICD-OKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF1","description":"ICD-KCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA1","description":"ICD-BBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99458","description":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF1","description":"ICD-PDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9630","description":"No vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF0","description":"ICD-DGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc pract mgmt differs trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9057","description":"Onc pract mgmt differs trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay free hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83500","description":"Assay free hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF1","description":"ICD-PIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB0","description":"ICD-CHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF1","description":"ICD-MEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revitalon 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4157","description":"Revitalon 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Matrl for vocal cord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1878","description":"Matrl for vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF0","description":"ICD-KGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0703","description":"HCPCS-C0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB1","description":"ICD-OECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD144","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec lock on manual pw elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6638","description":"Elec lock on manual pw elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33737","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF1","description":"ICD-GEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE1","description":"ICD-KCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC0","description":"ICD-KGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD0","description":"ICD-ADLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC1","description":"ICD-GFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat oblique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71022","description":"Chest x-ray frnt lat oblique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC1","description":"ICD-ECEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA1","description":"ICD-BHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC0","description":"ICD-JGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1558","description":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF0","description":"ICD-NFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ana crown exp 1-3 per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4231","description":"Ana crown exp 1-3 per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37258","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","description":"CPT-37258","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD0","description":"ICD-NKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anifrolumab-fnia_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0491","description":"Injection_ anifrolumab-fnia_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391U","description":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93320","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE1","description":"ICD-FBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90639","description":"CPT-90639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE0","description":"ICD-CHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA1","description":"ICD-CDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB136","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE1","description":"ICD-GBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1480","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","description":"HCPCS-M1480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE0","description":"ICD-EGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Followup eval of foot pt lop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0246","description":"Followup eval of foot pt lop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1107T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1107T","description":"CPT-1107T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86451","description":"Anesth removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE0","description":"ICD-CBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","description":"CPT-92288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA0","description":"ICD-CDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD1","description":"ICD-GCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27599","description":"Leg surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster integrated whl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2222","description":"Solid caster integrated whl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE136","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9069","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND1","description":"ICD-JHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD0","description":"ICD-DBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB1","description":"ICD-EHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND0","description":"ICD-JAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0944T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","description":"CPT-0944T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0695U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695U","description":"CPT-0695U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF1","description":"ICD-GICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA0","description":"ICD-GDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE1","description":"ICD-GDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant zonisamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80203","description":"Drug screen quant zonisamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44365","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD0","description":"ICD-GHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF0","description":"ICD-NDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93584","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0801","description":"HCPCS-B0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1577","description":"HCPCS-J1577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC0","description":"ICD-IEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8B","description":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd endo mucosal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43254","description":"Egd endo mucosal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE0","description":"ICD-NLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB0","description":"ICD-NGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dicom format doc on rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9340","description":"Dicom format doc on rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC1","description":"ICD-IIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA0","description":"ICD-MGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD0","description":"ICD-PLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27441","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc daily aspirin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9277","description":"Doc daily aspirin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284U","description":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5299","description":"Hearing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE1","description":"ICD-CBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable catheter tips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4860","description":"Disposable catheter tips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of quinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84228","description":"Assay of quinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5221","description":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE1","description":"ICD-BEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD0","description":"ICD-MIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA1","description":"ICD-GBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration behind abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49010","description":"Exploration behind abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF0","description":"ICD-AFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE1","description":"ICD-IDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch home day #2 cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8834","description":"Pt disch home day #2 cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC1","description":"ICD-GIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC0","description":"ICD-DESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD1","description":"ICD-JFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA1","description":"ICD-CCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA1","description":"ICD-CGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21248","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5173","description":"HCPCS-Q5173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE1","description":"ICD-JANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC0","description":"ICD-BFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB0","description":"ICD-CBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF1","description":"ICD-KBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91322","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA1","description":"ICD-FHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE1","description":"ICD-CBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33412","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC1","description":"ICD-CFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm pair no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0114","description":"Crutch underarm pair no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB1","description":"ICD-MGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl monofocl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92352","description":"Fit aphakia spectcl monofocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB0","description":"ICD-FATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ single chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1722","description":"Aicd_ single chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF0","description":"ICD-NDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20606","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD1","description":"ICD-KIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80331","description":"Analgesics non-opioid 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD1","description":"ICD-DAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Case presentation_ subsequent to detailed and extensive treatment planning","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9450","description":"Case presentation_ subsequent to detailed and extensive treatment planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m fanolesomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9566","description":"Tc99m fanolesomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF0","description":"ICD-HAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","description":"HCPCS-M1418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD101","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD106","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD0","description":"ICD-KGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE0","description":"ICD-CCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD0","description":"ICD-DHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF0","description":"ICD-CFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD0","description":"ICD-KHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF1","description":"ICD-JHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC0","description":"ICD-NCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal 3.1 to 6mg bupren","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0573","description":"Bupren/nal 3.1 to 6mg bupren","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2182","description":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0955T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","description":"CPT-0955T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA1","description":"ICD-OBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC1","description":"ICD-DHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA01","description":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow deb/attch open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24359","description":"Repair elbow deb/attch open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD1","description":"ICD-NGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD0","description":"ICD-BBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx complx malar w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21366","description":"Opn tx complx malar w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB0","description":"ICD-KCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31520","description":"Dx laryngoscopy newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD1","description":"ICD-EEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC1","description":"ICD-CIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF1","description":"ICD-HFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA1","description":"ICD-AAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA1","description":"ICD-MHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC31","description":"ICD-1IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE1","description":"ICD-KDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr source combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0491","description":"Emr pwr source combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC1","description":"ICD-CDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA1","description":"ICD-IBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ furosemide (furoscix)_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1941","description":"Injection_ furosemide (furoscix)_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33474","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disp wound suct_ drsg/access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9272","description":"Disp wound suct_ drsg/access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusion analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9950","description":"Occlusion analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX25","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE1","description":"ICD-MKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC1","description":"ICD-IELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical home_ initial plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0280","description":"Medical home_ initial plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA0","description":"ICD-IIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory surgical boot eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3260","description":"Ambulatory surgical boot eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA1","description":"ICD-CATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0799","description":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB0","description":"ICD-NHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9320","description":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF1","description":"ICD-NFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29887","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch home day #2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8826","description":"Pt disch home day #2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF0","description":"ICD-JGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3702","description":"Eo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement blood pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1620","description":"Replacement blood pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB1","description":"ICD-BDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33282","description":"Implantation of patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB1","description":"ICD-FDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA0","description":"ICD-FBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB1","description":"ICD-IGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Systemic corticosteroids rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4135F","description":"Systemic corticosteroids rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB1","description":"ICD-MLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58559","description":"Hysteroscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1785","description":"Pmkr_ dual_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0489T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB1","description":"ICD-IFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clamp neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61703","description":"Clamp neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC1","description":"ICD-ABLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE1","description":"ICD-IGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kerecis omega3 marigen shield_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2019","description":"Kerecis omega3 marigen shield_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9891","description":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth transmit_ per min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1014","description":"Telehealth transmit_ per min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tum incl acetabul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27076","description":"Resect hip tum incl acetabul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD0","description":"ICD-DHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE0","description":"ICD-NJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28320","description":"Repair of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA0","description":"ICD-FEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4015","description":"Neurology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sitting procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60451","description":"Anesth sitting procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26842","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial hip replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27125","description":"Partial hip replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38115","description":"Repair of ruptured spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","description":"HCPCS-M1429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB1","description":"ICD-CCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE0","description":"ICD-BGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0878T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD0","description":"ICD-BFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc mntl tst b/4 bk trxmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2044F","description":"Doc mntl tst b/4 bk trxmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE1","description":"ICD-OBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel pad removable for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3485","description":"Shoe heel pad removable for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC1","description":"ICD-PDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76497","description":"Ct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41512","description":"Tongue suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33257","description":"Ablate atria lmtd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC0","description":"ICD-NJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB0","description":"ICD-BBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15836","description":"Excise excessive skin arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC0","description":"ICD-OKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA0","description":"ICD-BENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atropine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7636","description":"Atropine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0537U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","description":"CPT-0537U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD0","description":"ICD-CBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29843","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0839T","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE0","description":"ICD-JFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD0","description":"ICD-KEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl counterpulse_ per tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0166","description":"Extrnl counterpulse_ per tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE0","description":"ICD-BDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC0","description":"ICD-PGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA1","description":"ICD-KDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB0","description":"ICD-ABLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74150","description":"Ct abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB1","description":"ICD-JDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","description":"CPT-90635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA0","description":"ICD-OETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7901","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81278","description":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA0","description":"ICD-HGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE0","description":"ICD-CBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92202","description":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB0","description":"ICD-MJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC0","description":"ICD-JBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB0","description":"ICD-BCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval aud rehab status","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92626","description":"Eval aud rehab status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33251","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC30","description":"Ultra High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provisional pontic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6253","description":"Provisional pontic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD0","description":"ICD-CBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB1","description":"ICD-KEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq lumbosacral injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22511","description":"Perq lumbosacral injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA0","description":"ICD-FFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 350-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9963","description":"Hocm 350-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE234","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF0","description":"ICD-JGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64809","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7220","description":"Impact tooth remov soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB0","description":"ICD-CCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt dchg home post op day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9601","description":"Pt dchg home post op day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB1","description":"ICD-OEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE1","description":"ICD-FGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF0","description":"ICD-NDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental tmj arthrogram incl i","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0320","description":"Dental tmj arthrogram incl i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC0","description":"ICD-OHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire_ integrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2392","description":"Solid caster tire_ integrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD1","description":"ICD-CFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9090","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5255","description":"Hearing aid_ digit_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE221","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34707","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF1","description":"ICD-KGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF0","description":"ICD-BCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45499","description":"Laparoscope proc rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47553","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA07","description":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD1","description":"ICD-AABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC0","description":"ICD-NEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF1","description":"ICD-CHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA0","description":"ICD-NAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD0","description":"ICD-OCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45334","description":"Sigmoidoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389U","description":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9794","description":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2360","description":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF1","description":"ICD-BGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0668T","description":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rx ace or arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8935","description":"Rx ace or arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF1","description":"ICD-LESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont insulin diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9353","description":"Hit cont insulin diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC15","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electromagnetic therapy onc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0295","description":"Electromagnetic therapy onc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0632U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0632U","description":"CPT-0632U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF1","description":"ICD-FDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC1","description":"ICD-OGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29800","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Powered air flotation bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0193","description":"Powered air flotation bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","description":"HCPCS-Q4404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA0","description":"ICD-CHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61460","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC1","description":"ICD-OHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF1","description":"ICD-DAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF1","description":"ICD-NJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DO GNOTYP ART4 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184U","description":"DO GNOTYP ART4 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF0","description":"ICD-EIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19367","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90961","description":"Esrd srv 2-3 vsts p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8912","description":"Mra w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28576","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85045","description":"Automated reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF0","description":"ICD-FGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB0","description":"ICD-CGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF1","description":"ICD-PFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 45","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88263","description":"Chromosome analysis 45","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB1","description":"ICD-MFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC1","description":"ICD-OGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC31","description":"ICD-2IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA07","description":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC1","description":"ICD-FEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF1","description":"ICD-GCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24200","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX52","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti rheum drugthxpyrxd/gvn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4187F","description":"Anti rheum drugthxpyrxd/gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA0","description":"ICD-MHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker monitr digital/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0615","description":"Pacemaker monitr digital/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB1","description":"ICD-GGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB1","description":"ICD-MJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB1","description":"ICD-FHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC160","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55500","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9770","description":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8B","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bilat dil retinal exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3000","description":"Bilat dil retinal exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth collar bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45451","description":"Anesth collar bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC1","description":"ICD-BAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE0","description":"ICD-GDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay test for blood fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82274","description":"Assay test for blood fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD1","description":"ICD-HCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC0","description":"ICD-OECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB1","description":"ICD-AABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE0","description":"ICD-KGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE1","description":"ICD-OKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB0","description":"ICD-KDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA1","description":"ICD-OBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF0","description":"ICD-JGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28705","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD0","description":"ICD-ICBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB1","description":"ICD-LHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"INTRAORIFICE BARRIER","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3911","description":"INTRAORIFICE BARRIER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2560","description":"Phenobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented above normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1293","description":"Bmi is documented above normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC0","description":"ICD-FBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC0","description":"ICD-OHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoperfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90997","description":"Hemoperfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB0","description":"ICD-FBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF0","description":"ICD-KBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vasopressin_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2598","description":"Injection_ vasopressin_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc tb scrng-rslts interpd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3510F","description":"Doc tb scrng-rslts interpd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58976","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD1","description":"ICD-NCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA0","description":"ICD-OHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF0","description":"ICD-MGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tooth socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41874","description":"Repair tooth socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE1","description":"ICD-KFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation heart device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93640","description":"Evaluation heart device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB1","description":"ICD-JFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB1","description":"ICD-PFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC1","description":"ICD-OKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC1","description":"ICD-OCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15834","description":"Excise excessive skin hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC1","description":"ICD-MGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE1","description":"ICD-KGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop applicat rigid dsg on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6388","description":"Postop applicat rigid dsg on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB1","description":"ICD-MCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2214","description":"Pneumatic caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC31","description":"ICD-2FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED0","description":"ICD-KGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF0","description":"ICD-CDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0079U","description":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97813","description":"Acupunct w/stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF1","description":"ICD-GETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB1","description":"ICD-OBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC0","description":"ICD-BEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD1","description":"ICD-BGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porc 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2630","description":"Dental onlay porc 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA1","description":"ICD-KCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB1","description":"ICD-OKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA0","description":"ICD-JDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB1","description":"ICD-DBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD0","description":"ICD-OEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services received by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9692","description":"Hospice services received by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ dual chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1721","description":"Aicd_ dual chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB226","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0582U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","description":"CPT-0582U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cus elbo skt in for con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6696","description":"Cus elbo skt in for con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB0","description":"ICD-GATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8C","description":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF1","description":"ICD-JHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1020","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53220","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27176","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfacon-1 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9212","description":"Interferon alfacon-1 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE0","description":"ICD-AGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF0","description":"ICD-OFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA1","description":"ICD-FGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC0","description":"ICD-CHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD0","description":"ICD-GBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noc retail items andsupplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1999","description":"Noc retail items andsupplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flu vacc iiv3 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90654","description":"Flu vacc iiv3 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA1","description":"ICD-AGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD0","description":"ICD-OFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 10-15dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0303","description":"Pre-op service lvrs 10-15dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77261","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF0","description":"ICD-NIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC1","description":"ICD-PKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB21","description":"ICD-3IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE1","description":"ICD-BCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed bilat space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1515","description":"Fixed bilat space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF0","description":"ICD-GEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cancer stage docd metast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3301F","description":"Cancer stage docd metast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of arm & girdle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23900","description":"Amputation of arm & girdle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lat retinacular release open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27425","description":"Lat retinacular release open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD0","description":"ICD-IGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF1","description":"ICD-JCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE1","description":"ICD-PJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB1","description":"ICD-NGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE1","description":"ICD-CEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD0","description":"ICD-NCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC0","description":"ICD-MFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1803","description":"HCPCS-B1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC120","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9727","description":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC35","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraoral first film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0250","description":"Extraoral first film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2215","description":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA21","description":"ICD-1LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF1","description":"ICD-OEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB1","description":"ICD-BIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC1","description":"ICD-FBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc scr uter mal or us/samp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9618","description":"Doc scr uter mal or us/samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME0","description":"ICD-CDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28294","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","description":"HCPCS-M1395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1229","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interim implant crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6085","description":"Interim implant crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis access study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90940","description":"Hemodialysis access study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA0","description":"ICD-HHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB1","description":"ICD-NKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Halo cervical into body jack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0820","description":"Halo cervical into body jack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L0720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","description":"HCPCS-L0720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF1","description":"ICD-JHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD0","description":"ICD-EGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED0","description":"ICD-NJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE135","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC0","description":"ICD-NEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA0","description":"ICD-BGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE0","description":"ICD-HGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","description":"CPT-97008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cycler dialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1594","description":"Cycler dialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81418","description":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD1","description":"ICD-IFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD0","description":"ICD-BITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heat & moisture exchange sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7509","description":"Heat & moisture exchange sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF0","description":"ICD-OBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC1","description":"ICD-CFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD1","description":"ICD-PLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not initial eval for cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1501F","description":"Not initial eval for cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99222","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND0","description":"ICD-KAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9811","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9811","description":"HCPCS-C9811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB56","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virus antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86790","description":"Virus antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE0","description":"ICD-JHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor fletcher fact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85292","description":"Clot factor fletcher fact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb musc/fascia 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11043","description":"Deb musc/fascia 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC0","description":"ICD-HFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temple bne implnt w/stimulat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69715","description":"Temple bne implnt w/stimulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD0","description":"ICD-CBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC1","description":"ICD-MDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins tun ip cath for dial opn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49421","description":"Ins tun ip cath for dial opn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC0","description":"ICD-ADMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD1","description":"ICD-LESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adlt disp und/pull on abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4544","description":"Adlt disp und/pull on abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA0","description":"ICD-NHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27286","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC0","description":"ICD-LFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB0","description":"ICD-MCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0681T","description":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3356","description":"Pulpal regeneration interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC1","description":"ICD-KBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins mark abd/pel for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49411","description":"Ins mark abd/pel for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cardiac electrophys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53751","description":"Anesth cardiac electrophys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0081","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2608","description":"Skin pro/pos wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA0","description":"ICD-PCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA0","description":"ICD-AIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA1","description":"ICD-ADUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD0","description":"ICD-OLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC0","description":"ICD-KCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB0","description":"ICD-IAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB0","description":"ICD-KDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntiol category 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1004","description":"Ntiol category 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multisys ther/juvenile 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2033","description":"Multisys ther/juvenile 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA0","description":"ICD-KAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-hemophil diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9345","description":"Hit anti-hemophil diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"GE GNOTYP GYPC EXONS 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188U","description":"GE GNOTYP GYPC EXONS 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF1","description":"ICD-OJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1832","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","description":"HCPCS-E1832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA0","description":"ICD-IDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE1","description":"ICD-CFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD1","description":"ICD-KAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF0","description":"ICD-IFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj growth horm diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9558","description":"Ht inj growth horm diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC1","description":"ICD-AADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sng/dbl mechanical act","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2005","description":"Kafo sng/dbl mechanical act","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rear whl compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0070","description":"Rear whl compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC0","description":"ICD-GCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF0","description":"ICD-PFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA0","description":"ICD-AHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB1","description":"ICD-OFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF1","description":"ICD-JFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq sacral augmt unilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200T","description":"Perq sacral augmt unilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD0","description":"ICD-OBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF1","description":"ICD-BAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA0","description":"ICD-JFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68362","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE1","description":"ICD-KEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA0","description":"ICD-BETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA0","description":"ICD-OJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD1","description":"ICD-JIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine patch nonlegend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4991","description":"Nicotine patch nonlegend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC1","description":"ICD-EBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2053","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC0","description":"ICD-FILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no dchg home postop day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9602","description":"Pt no dchg home postop day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b core antibody total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86704","description":"Hep b core antibody total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc harness_ expand control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2313","description":"Pwc harness_ expand control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0002","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpt doc class histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9422","description":"Rpt doc class histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prior history of known cvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1256","description":"Prior history of known cvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PrecisionBlood™_ San Diego Blood Bank","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0246U","description":"PrecisionBlood™_ San Diego Blood Bank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE1","description":"ICD-FAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE1","description":"ICD-BHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA1","description":"ICD-MDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC0","description":"ICD-GCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","description":"CPT-87626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC0","description":"ICD-IFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA1","description":"ICD-GEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA1","description":"ICD-BFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54125","description":"Removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath occlusion non-cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61626","description":"Transcath occlusion non-cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE1","description":"ICD-BGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96101","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF0","description":"ICD-KCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repeat control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30906","description":"Repeat control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC1","description":"ICD-NDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD1","description":"ICD-KBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF1","description":"ICD-MGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analys placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88267","description":"Chromosome analys placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE1","description":"ICD-BFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC210","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC1","description":"ICD-MFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE0","description":"ICD-EATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD1","description":"ICD-HCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unsched dialysis esrd pt hos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0257","description":"Unsched dialysis esrd pt hos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC11","description":"ICD-2FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD1","description":"ICD-KIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophageal sphincter augmentation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43285","description":"Removal of esophageal sphincter augmentation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB1","description":"ICD-CDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD1","description":"ICD-OHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE0","description":"ICD-JIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB0","description":"ICD-KAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC0","description":"ICD-OHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Salmonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86768","description":"Salmonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD0","description":"ICD-MDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE1","description":"ICD-NJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD0","description":"ICD-AGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0289","description":"Amphotericin b liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA1","description":"ICD-CDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB1","description":"ICD-GAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx deli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90868","description":"Tcranial magn stim tx deli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Finger splint_ static","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4049","description":"Finger splint_ static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB1","description":"ICD-GCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cholera vaccine live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90625","description":"Cholera vaccine live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD1","description":"ICD-IBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA1","description":"ICD-MGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE1","description":"ICD-CBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1010","description":"Add pwr leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB1","description":"ICD-OFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX16","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52283","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Helicobacter pylori antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86677","description":"Helicobacter pylori antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB1","description":"ICD-EIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc of non tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9275","description":"Doc of non tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC1","description":"ICD-EETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB0","description":"ICD-FEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq tx malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21355","description":"Perq tx malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD1","description":"ICD-GAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6500","description":"Above elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73050","description":"X-ray exam of shoulders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg over 1 hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95813","description":"Eeg over 1 hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE1","description":"ICD-CADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB0","description":"ICD-JIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47610","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29850","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE1","description":"ICD-MJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA0","description":"ICD-EBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC1","description":"ICD-GDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC1","description":"ICD-BHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63103","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE0","description":"ICD-MIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB1","description":"ICD-CERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD0","description":"ICD-GFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Matrion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4201","description":"Matrion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF0","description":"ICD-NJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0403","description":"CDT-D0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF1","description":"ICD-EGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB0","description":"ICD-KEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28309","description":"Incision of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD0","description":"ICD-GGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB02","description":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc lis nurse train ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0164","description":"Hhc lis nurse train ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA1","description":"ICD-AGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF1","description":"ICD-OCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24516","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB1","description":"ICD-DFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc acc_ lith-based battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2397","description":"Pwc acc_ lith-based battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF0","description":"ICD-GCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27681","description":"Release of lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0673U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673U","description":"CPT-0673U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiviral not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9244","description":"Antiviral not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB0","description":"ICD-OISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay galactose transferase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82775","description":"Assay galactose transferase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 7.12-20.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2202","description":"Lens sphere bifocal 7.12-20.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1A","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD1","description":"ICD-IAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD1","description":"ICD-NFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36248","description":"Ins cath abd/l-ext art addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apomorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0364","description":"Apomorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE0","description":"ICD-JDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0B","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE0","description":"ICD-BANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj intercost mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64421","description":"N block inj intercost mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB1","description":"ICD-MBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND0","description":"ICD-FIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF0","description":"ICD-EAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC31","description":"ICD-3GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC0","description":"ICD-CIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC0","description":"ICD-CAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB0","description":"ICD-AICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31293","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449U","description":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatoid factor quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86431","description":"Rheumatoid factor quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA1","description":"ICD-BCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable underpads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4554","description":"Disposable underpads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa complexed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84152","description":"Assay of psa complexed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC0","description":"ICD-CFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89291","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4223","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4223","description":"HCPCS-Q4223","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63016","description":"Remove spine lamina >2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE115","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF0","description":"ICD-EDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD1","description":"ICD-NLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC1","description":"ICD-KFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC1","description":"ICD-CETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC1","description":"ICD-MCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reticyte/hgb concentrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85046","description":"Reticyte/hgb concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD1","description":"ICD-FFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE0","description":"ICD-GAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oligoclonal bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83916","description":"Oligoclonal bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA0","description":"ICD-GEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD160","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90721","description":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF1","description":"ICD-ABTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26567","description":"Correct finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD0","description":"ICD-JFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8E","description":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE0","description":"ICD-AGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd diagnostic brush wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43235","description":"Egd diagnostic brush wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA0","description":"ICD-GDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Position wc cush wdth>=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2606","description":"Position wc cush wdth>=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE0","description":"ICD-EFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81403","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78816","description":"Pet image w/ct full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC0","description":"ICD-NBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24115","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko double upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1845","description":"Ko double upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD0","description":"ICD-NEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB0","description":"ICD-OCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal therapy posterior pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3240","description":"Pulpal therapy posterior pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE1","description":"ICD-JHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA1","description":"ICD-OCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD1","description":"ICD-GFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC0","description":"ICD-BBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6614","description":"Onlay cst nbl mtl 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF0","description":"ICD-LIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB0","description":"ICD-FADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy microsurg graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15842","description":"Nerve palsy microsurg graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX26","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nras gene variants exon 2&3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81311","description":"Nras gene variants exon 2&3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 3.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4168","description":"Parenteral sol amino acid 3.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cont airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0601","description":"Cont airway pressure device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of palm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26025","description":"Drainage of palm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE1","description":"ICD-CEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stimulated iui case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4035","description":"Stimulated iui case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF0","description":"ICD-DIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0542","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","description":"HCPCS-G0542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So airplane w/wo joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3674","description":"So airplane w/wo joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF0","description":"ICD-OGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colectomy w/neo-rectum pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44158","description":"Colectomy w/neo-rectum pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26350","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair anomaly w/conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33608","description":"Repair anomaly w/conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Current tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1316","description":"Current tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE1","description":"ICD-CAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME0","description":"ICD-FIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD0","description":"ICD-OGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5137","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4263","description":"Surgraft tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309U","description":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB1","description":"ICD-MDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB0","description":"ICD-CDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1020","description":"Clinical decision support mechanism curbside clinical augmented workflow_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA1","description":"ICD-MFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD1","description":"ICD-DEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD1","description":"ICD-OJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB1","description":"ICD-NGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE235","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB01","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE1","description":"ICD-BGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76390","description":"Mr spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB0","description":"ICD-KATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND0","description":"ICD-GFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC216","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB0","description":"ICD-JDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63744","description":"Revision of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 15-21 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0482","description":"Drug test def 15-21 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36482","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF0","description":"ICD-DFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25535","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reverse osmosis h2o puri sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1610","description":"Reverse osmosis h2o puri sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC1","description":"ICD-KBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine shunt to intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50815","description":"Urine shunt to intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA0","description":"ICD-ECAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein l3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82107","description":"Alpha-fetoprotein l3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC0","description":"ICD-MCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2047","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2047","description":"HCPCS-A2047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL45","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of etiocholanolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82696","description":"Assay of etiocholanolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF0","description":"ICD-DCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3473","description":"Surgical repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB1","description":"ICD-JHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD0","description":"ICD-CCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF0","description":"ICD-FDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE0","description":"ICD-GEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB0","description":"ICD-AEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF0","description":"ICD-GHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Russell viper venom diluted","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85613","description":"Russell viper venom diluted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62290","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0890T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC1","description":"ICD-JEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8610","description":"Ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA1","description":"ICD-MKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD1","description":"ICD-AGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD1","description":"ICD-ABBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD1","description":"ICD-NHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401U","description":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61735","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF0","description":"ICD-GCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33514","description":"Cabg vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX23","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lithium batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4235","description":"Lithium batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid frame hyperex pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0472","description":"Tlso rigid frame hyperex pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE1","description":"ICD-OFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA1","description":"ICD-EGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB1","description":"ICD-GEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA50","description":"Default_ /90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE1","description":"ICD-AATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE1","description":"ICD-GABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0814","description":"Pwc gp 1 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82627","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA1","description":"ICD-IICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1220","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF0","description":"ICD-MBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Free jejunum flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43496","description":"Free jejunum flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB0","description":"ICD-NGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC110","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC1","description":"ICD-EIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carpal tunnel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64721","description":"Carpal tunnel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 3 dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90634","description":"Hepa vacc ped/adol 3 dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43195","description":"Esophagoscopy rigid balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF1","description":"ICD-LAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB1","description":"ICD-JHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gabapentin non-blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80355","description":"Gabapentin non-blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25110","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prealbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84134","description":"Assay of prealbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82488","description":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE0","description":"ICD-JDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31725","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11107","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44970","description":"Laparoscopy appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epifix_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4145","description":"Epifix_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc cur funct assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8541","description":"No doc cur funct assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA11","description":"ICD-1AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE1","description":"ICD-JAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE0","description":"ICD-DISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF1","description":"ICD-EDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0620","description":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC1","description":"ICD-MLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB0","description":"ICD-CGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME1","description":"ICD-ACME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB0","description":"ICD-CBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE0","description":"ICD-MGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF0","description":"ICD-NCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl cardiac modulj pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412T","description":"Rmvl cardiac modulj pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE1","description":"ICD-HHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27369","description":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","description":"CPT-70472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC1","description":"ICD-GGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ptfalls assess-docd ge2>/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1100F","description":"Ptfalls assess-docd ge2>/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA1","description":"ICD-CBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC1","description":"ICD-KBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF0","description":"ICD-OKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hf mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8551","description":"Hf mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9721","description":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9292","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","description":"HCPCS-J9292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB0","description":"ICD-DHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC1","description":"ICD-ACLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pituitary evaluation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80418","description":"Pituitary evaluation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc compl inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9301","description":"Doc compl inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB1","description":"ICD-MDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93244","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrmng 4 surg normothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4250F","description":"Wrmng 4 surg normothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF0","description":"ICD-KATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4335","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","description":"HCPCS-Q4335","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43882","description":"Revise/remove electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC0","description":"ICD-OBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46610","description":"Anoscopy remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44145","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair detachable arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1060","description":"Wheelchair detachable arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE1","description":"ICD-ACHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occluder lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2770","description":"Occluder lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED1","description":"ICD-KHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA21","description":"ICD-1CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB241","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB1","description":"ICD-PCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF0","description":"ICD-OFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture ulnar styloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25652","description":"Treat fracture ulnar styloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX24","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB1","description":"ICD-CCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer w/ compressor & he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0585","description":"Nebulizer w/ compressor & he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB0","description":"ICD-MJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3913","description":"Hfo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0570U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","description":"CPT-0570U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB0","description":"ICD-FELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE1","description":"ICD-CIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB0","description":"ICD-IDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE226","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD1","description":"ICD-JDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC1","description":"ICD-CDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF1","description":"ICD-EFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable peak flow meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8096","description":"Portable peak flow meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD0","description":"ICD-FHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sealant_ pulmonary_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2615","description":"Sealant_ pulmonary_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer with compression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0570","description":"Nebulizer with compression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Renal abscess open drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50020","description":"Renal abscess open drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hrt surg w/pmp age 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56251","description":"Anesth hrt surg w/pmp age 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB201","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA10","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB21","description":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX06","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elect stim wound care not pd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0282","description":"Elect stim wound care not pd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft f/n/hfg add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15156","description":"Cult skin grft f/n/hfg add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61026","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE0","description":"ICD-KASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81361","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA0","description":"ICD-GIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43312","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69667","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA145","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC0","description":"ICD-FHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE0","description":"ICD-CGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD1","description":"ICD-GCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB1","description":"ICD-OLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB1","description":"ICD-BEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB1","description":"ICD-BFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cholinesterase challenge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95857","description":"Cholinesterase challenge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24498","description":"Reinforce humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF1","description":"ICD-CASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC1","description":"ICD-EEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB0","description":"ICD-CILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE0","description":"ICD-GFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44156","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1101","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB0","description":"ICD-BEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB0","description":"ICD-NDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB1","description":"ICD-CHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE0","description":"ICD-KDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte histamine release","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86343","description":"Leukocyte histamine release","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21485","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE0","description":"ICD-CEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC0","description":"ICD-KDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD1","description":"ICD-CBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair anti-tipping devi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0971","description":"Wheelchair anti-tipping devi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise temple bone implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69718","description":"Revise temple bone implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC16","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD0","description":"ICD-MLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD1","description":"ICD-PDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54115","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nivolumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9299","description":"Injection_ nivolumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4A","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB1","description":"ICD-AFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor ii prothrom spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85210","description":"Clot factor ii prothrom spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82103","description":"Alpha-1-antitrypsin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE1","description":"ICD-GEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE0","description":"ICD-OHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pne scrn done doc vac done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9279","description":"Pne scrn done doc vac done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF1","description":"ICD-EBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2B","description":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF1","description":"ICD-BCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA0","description":"ICD-OCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33970","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC0","description":"ICD-FALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB1","description":"ICD-KFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE0","description":"ICD-GICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dose optimization auc - 5fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3722","description":"Dose optimization auc - 5fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7288","description":"Brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA0","description":"ICD-PARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25024","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD217","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD130","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB0","description":"ICD-PJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26844","description":"Fusion/graft of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF0","description":"ICD-KBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF1","description":"ICD-AGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE1","description":"ICD-HFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","description":"HCPCS-J3374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87593","description":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL30","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77763","description":"Apply intrcav radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise cerv artific disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22861","description":"Revise cerv artific disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD0","description":"ICD-NCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF1","description":"ICD-OIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE1","description":"ICD-OFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA21","description":"ICD-4CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces/urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84577","description":"Assay of feces/urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD1","description":"ICD-PIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sodium fluoride f-18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9580","description":"Sodium fluoride f-18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5134","description":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD1","description":"ICD-BEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD1","description":"ICD-AEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88302","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC1","description":"ICD-KIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF0","description":"ICD-FBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88366","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF0","description":"ICD-BHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE1","description":"ICD-IFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance 02 life sustaining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0422","description":"Ambulance 02 life sustaining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deluxe lens feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2702","description":"Deluxe lens feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD1","description":"ICD-GEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD1","description":"ICD-GCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6253","description":"Absorpt drg > 48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gear reduction drive wheel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2227","description":"Gear reduction drive wheel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE0","description":"ICD-OLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB1","description":"ICD-KFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463U","description":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75736","description":"Artery x-rays pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD1","description":"ICD-NKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF0","description":"ICD-KDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA0","description":"ICD-CIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg strap h style each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0039","description":"Leg strap h style each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND1","description":"ICD-FGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA0","description":"ICD-FDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF0","description":"ICD-AELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE1","description":"ICD-KAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB0","description":"ICD-NAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB0","description":"ICD-FHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csi any other than pci 2 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8964","description":"Csi any other than pci 2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214U","description":"RARE DS XOM DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow up pulm nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9345","description":"Follow up pulm nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA1","description":"ICD-OACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF1","description":"ICD-IEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC1","description":"ICD-CDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE1","description":"ICD-BBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53515","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth trachea bronchi surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54851","description":"Anesth trachea bronchi surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB1","description":"ICD-PDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA1","description":"ICD-JGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC0","description":"ICD-AAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PolyCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4241","description":"PolyCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total knee arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27447","description":"Total knee arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB0","description":"ICD-GENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA0","description":"ICD-NDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk knee joints single axis p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5676","description":"Bk knee joints single axis p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE0","description":"ICD-CGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 xhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0864","description":"Pwc gp3 xhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC0","description":"ICD-FEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioCyte Plus_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4242","description":"AmnioCyte Plus_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0640U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0640U","description":"CPT-0640U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1106T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1106T","description":"CPT-1106T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or wo fol wcon_doppler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8929","description":"Tte w or wo fol wcon_doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF1","description":"ICD-ADIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0803","description":"CDT-D0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc active inj drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9518","description":"Doc active inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation supply sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4397","description":"Irrigation supply sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2100","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC1","description":"ICD-FGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD1","description":"ICD-EGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB0","description":"ICD-CEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6584","description":"Elbow fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic pancreatoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43273","description":"Endoscopic pancreatoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Haloperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1630","description":"Haloperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63266","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63191","description":"Incise spine accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB17","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm np 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99605","description":"Mtms by pharm np 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE1","description":"ICD-KEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE140","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1045T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1045T","description":"CPT-1045T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA0","description":"ICD-CIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF1","description":"ICD-NITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","description":"CPT-01160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC0","description":"ICD-CFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD0","description":"ICD-BIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace ureter by bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50840","description":"Replace ureter by bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB110","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA0","description":"ICD-OANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE0","description":"ICD-HDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete cbc automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85027","description":"Complete cbc automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD1","description":"ICD-LEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj testostero enanthate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3121","description":"Inj testostero enanthate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lungs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75743","description":"Artery x-rays lungs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF0","description":"ICD-NBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB0","description":"ICD-OCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF1","description":"ICD-MJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast supplies (plaster)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4580","description":"Cast supplies (plaster)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2015","description":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE1","description":"ICD-HBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF1","description":"ICD-FCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advancing Care For Heart Disease Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0055","description":"Advancing Care For Heart Disease Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9985","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83527","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skel musc relaxant 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80370","description":"Skel musc relaxant 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88334","description":"Intraop cyto path consult 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD1","description":"ICD-MEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC0","description":"ICD-BBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD0","description":"ICD-HDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0832T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj aspiration joint fluid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7870","description":"Tmj aspiration joint fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF1","description":"ICD-GDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE0","description":"ICD-KFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF0","description":"ICD-BFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34471","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC1","description":"ICD-KHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csit perf sx or high chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8966","description":"Csit perf sx or high chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6410","description":"Sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC1","description":"ICD-LBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7308","description":"Aminolevulinic acid hcl top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22116","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD1","description":"ICD-GBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC0","description":"ICD-JIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrodiag polyneuro 6 mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3751F","description":"Electrodiag polyneuro 6 mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj milrinone lactate / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2260","description":"Inj milrinone lactate / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB1","description":"ICD-CIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB0","description":"ICD-PKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD1","description":"ICD-NBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fas/dir ldl 70-189mg/dl mst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9666","description":"Fas/dir ldl 70-189mg/dl mst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE1","description":"ICD-FADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA1","description":"ICD-EAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cord blood-derived stem-cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2142","description":"Cord blood-derived stem-cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF1","description":"ICD-OGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF0","description":"ICD-JIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES111","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF1","description":"ICD-FEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA1","description":"ICD-OKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA0","description":"ICD-KCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE0","description":"ICD-MLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55708","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","description":"CPT-55708","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA1","description":"ICD-OFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5950","description":"Endo ak ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE0","description":"ICD-EDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE1","description":"ICD-BCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE0","description":"ICD-JFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD1","description":"ICD-PERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15738","description":"Muscle-skin graft leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE1","description":"ICD-BHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE1","description":"ICD-KFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove nail plate add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11732","description":"Remove nail plate add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1010","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of beta-2 protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82232","description":"Assay of beta-2 protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD1","description":"ICD-CFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB21","description":"ICD-4FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF0","description":"ICD-OANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE0","description":"ICD-JIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1024T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","description":"CPT-1024T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35476","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE1","description":"ICD-BGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA0","description":"ICD-KDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dalbavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0875","description":"Injection_ dalbavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise kidney blood vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50100","description":"Revise kidney blood vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE1","description":"ICD-GHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF1","description":"ICD-EBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB217","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6234","description":"Hydrocolld drg <=16 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC1","description":"ICD-AFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC1","description":"ICD-MKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC1","description":"ICD-OCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB0","description":"ICD-NHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levorphanol tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1960","description":"Levorphanol tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","description":"HCPCS-L6035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe sole wedge outside sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3360","description":"Shoe sole wedge outside sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD0","description":"ICD-PJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53060","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block spenopalatine gangl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64505","description":"N block spenopalatine gangl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7648","description":"Isoetharine non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1067","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc otc assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1007F","description":"Anti-inflm/anlgsc otc assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fomepizole_ 15 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1451","description":"Fomepizole_ 15 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC0","description":"ICD-BCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE1","description":"ICD-JAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF0","description":"ICD-IDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF0","description":"ICD-NGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE0","description":"ICD-GBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD0","description":"ICD-GAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gait training therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97116","description":"Gait training therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23630","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1001","description":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD0","description":"ICD-KGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1043","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB0","description":"ICD-NJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC21","description":"ICD-1DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC1","description":"ICD-JDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB1","description":"ICD-CECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64583","description":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD1","description":"ICD-OFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA21","description":"ICD-3KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA0","description":"ICD-MKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID0","description":"ICD-AAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE0","description":"ICD-CBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_5%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9041","description":"Albumin (human)_5%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dissect brain w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62161","description":"Dissect brain w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD0","description":"ICD-AFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD1","description":"ICD-NIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntr interr eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306T","description":"Icar ischm mntr interr eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA0","description":"ICD-MAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2061","description":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE0","description":"ICD-CDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cine/video x-rays add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76125","description":"Cine/video x-rays add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90483","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","description":"CPT-90483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE1","description":"ICD-AGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methadone oral 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0109","description":"Methadone oral 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA131","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED0","description":"ICD-FBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC1","description":"ICD-MFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA1","description":"ICD-GICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aor-celiac-msn-renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35631","description":"Art byp aor-celiac-msn-renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5244","description":"Hearing aid_ prog_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1022","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1022","description":"HCPCS-E1022","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9820","description":"Documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intl custm cong/latyp insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5681","description":"Intl custm cong/latyp insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27635","description":"Remove lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA0","description":"ICD-JCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restraints any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0710","description":"Restraints any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC1","description":"ICD-FIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE0","description":"ICD-HAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power module combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0479","description":"Power module combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD0","description":"ICD-OGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adalimumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80145","description":"Adalimumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF0","description":"ICD-CBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA1","description":"ICD-ABEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA1","description":"ICD-HBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36014","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resin two surfaces-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2331","description":"Resin two surfaces-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA1","description":"ICD-CCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50075","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/o inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93892","description":"Tcd emboli detect w/o inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE0","description":"ICD-OGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA1","description":"ICD-GIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC31","description":"ICD-4KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metl 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2544","description":"Dental onlay metl 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate w/rise psa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9080","description":"Onc dx prostate w/rise psa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Memory d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9170","description":"Memory d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA0","description":"ICD-MHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1504","description":"HCPCS-A1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic therapy stroke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37195","description":"Thrombolytic therapy stroke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF0","description":"ICD-NLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45390","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED1","description":"ICD-FEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elective surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9643","description":"Elective surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC0","description":"ICD-CFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC0","description":"ICD-GERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint of lwr extr w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73722","description":"MRI joint of lwr extr w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB0","description":"ICD-HBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1221","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF1","description":"ICD-KESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF0","description":"ICD-CFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate renal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50541","description":"Laparo ablate renal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12044","description":"Intmd rpr n-hf/genit7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC1","description":"ICD-LFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL20","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attendant Care Services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1793","description":"Attendant Care Services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of inner eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67036","description":"Removal of inner eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-H0052","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","description":"HCPCS-H0052","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flt3 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81245","description":"Flt3 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB1","description":"ICD-LBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD0","description":"ICD-EAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23101","description":"Shoulder joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB1","description":"ICD-MIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE1","description":"ICD-ECCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87556","description":"M.tuberculo dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF0","description":"ICD-JIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB1","description":"ICD-GEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2044","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","description":"HCPCS-A2044","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62140","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB0","description":"ICD-CIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD0","description":"ICD-EETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE0","description":"ICD-FDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE0","description":"ICD-ICCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD1","description":"ICD-OFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD1","description":"ICD-GGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF1","description":"ICD-KFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88036","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Congo red blood test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2029","description":"Congo red blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69644","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF1","description":"ICD-FGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID1","description":"ICD-OLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord vsls crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63250","description":"Revise spinal cord vsls crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD1","description":"ICD-HAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB31","description":"ICD-1AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA22","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC0","description":"ICD-OFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB0","description":"ICD-KEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37256","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","description":"CPT-37256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA0","description":"ICD-BIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD1","description":"ICD-MABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dias bp less 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8754","description":"Dias bp less 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0711T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB0","description":"ICD-ODMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43652","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE125","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90704","description":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB1","description":"ICD-KIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9784","description":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86658","description":"Enterovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC1","description":"ICD-NHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF1","description":"ICD-GHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1085T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1085T","description":"CPT-1085T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0320U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7545","description":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA1","description":"ICD-KCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD0","description":"ICD-KHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69642","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA0","description":"ICD-NLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC1","description":"ICD-FDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radium/radioisotope therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77799","description":"Radium/radioisotope therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1040","description":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC1","description":"ICD-NHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME0","description":"ICD-IAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF1","description":"ICD-ADUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE0","description":"ICD-IFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md certification hha patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0180","description":"Md certification hha patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF1","description":"ICD-KBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD1","description":"ICD-GICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF1","description":"ICD-OFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE0","description":"ICD-OENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frnt cstr cmpl sem-pneum tir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0072","description":"Frnt cstr cmpl sem-pneum tir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD1","description":"ICD-EGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj dihydroergotamine mesylt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1110","description":"Inj dihydroergotamine mesylt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp ea 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99145","description":"Mod sedat phys/qhp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF1","description":"ICD-OLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE0","description":"ICD-BGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA0","description":"ICD-JBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0726T","description":"Removal of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9796","description":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE1","description":"ICD-JFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID0","description":"ICD-BGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA31","description":"ICD-3LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1201","description":"Injection_ cetirizine hydrochloride_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD0","description":"ICD-JEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA1","description":"ICD-OGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB1","description":"ICD-GFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE1","description":"ICD-EGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD0","description":"ICD-KISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID0","description":"ICD-CGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27040","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54430","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE1","description":"ICD-OHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibody detection nos if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87299","description":"Antibody detection nos if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB1","description":"ICD-BBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB0","description":"ICD-ICUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF1","description":"ICD-FCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87475","description":"Lyme dis dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1072T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1072T","description":"CPT-1072T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maxillary sinusotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7560","description":"Maxillary sinusotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA0","description":"ICD-LEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0873","description":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB0","description":"ICD-AADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD1","description":"ICD-KHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anter chamber intraocul lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2630","description":"Anter chamber intraocul lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF1","description":"ICD-OBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy prostatic imp 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9739","description":"Cystoscopy prostatic imp 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD0","description":"ICD-MKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC32","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB1","description":"ICD-JFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE0","description":"ICD-NKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8F","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50715","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Online e/m by phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99444","description":"Online e/m by phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF0","description":"ICD-MGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD0","description":"ICD-NDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF1","description":"ICD-BFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF1","description":"ICD-JDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF0","description":"ICD-CHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF0","description":"ICD-CEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Approp oral rehyd recommd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4056F","description":"Approp oral rehyd recommd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD1","description":"ICD-EDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL24","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE1","description":"ICD-LGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF1","description":"ICD-GBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES250","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA11","description":"ICD-2HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB0","description":"ICD-GGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD0","description":"ICD-IFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA1","description":"ICD-NGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA1","description":"ICD-GBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB1","description":"ICD-IDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA1","description":"ICD-GEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific igg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86001","description":"Allergen specific igg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF0","description":"ICD-JFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE1","description":"ICD-CASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF0","description":"ICD-IHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB0","description":"ICD-GIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Distal/proximal wedge proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4274","description":"Distal/proximal wedge proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB0","description":"ICD-NJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","description":"CPT-64656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg/ankle surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27899","description":"Leg/ankle surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB1","description":"ICD-GAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE0","description":"ICD-KCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC1","description":"ICD-GDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:15)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1741","description":"Employment - Employment Skills Development (1:15)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection estrone per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1435","description":"Injection estrone per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465U","description":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF0","description":"ICD-GBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB40","description":"Medium Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB1","description":"ICD-KFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0061","description":"Anesthesiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA1","description":"ICD-CCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67108","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB1","description":"ICD-GELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehabilitation pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9473","description":"Pulmonary rehabilitation pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6614","description":"HCPCS-A6614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE1","description":"ICD-FIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE0","description":"ICD-LBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36262","description":"Removal of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral fludarabine phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8562","description":"Oral fludarabine phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD0","description":"ICD-LGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC1","description":"ICD-OGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC0","description":"ICD-NJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31300","description":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA0","description":"ICD-PDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ caplacizumab-yhdp_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9047","description":"Injection_ caplacizumab-yhdp_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD0","description":"ICD-OIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5699","description":"Shoulder harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init day hosp neonate care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99477","description":"Init day hosp neonate care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE0","description":"ICD-OIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE0","description":"ICD-MGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC1","description":"ICD-GFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD0","description":"ICD-PCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA0","description":"ICD-MIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0724T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB0","description":"ICD-BGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB0","description":"ICD-OBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96415","description":"Chemo iv infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB231","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA21","description":"ICD-4FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA0","description":"ICD-BAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE1","description":"ICD-KAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD0","description":"ICD-BDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE0","description":"ICD-HBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE0","description":"ICD-IDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC0","description":"ICD-JDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE1","description":"ICD-OAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB135","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB1","description":"ICD-BBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0540U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","description":"CPT-0540U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of pancreatic cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48500","description":"Surgery of pancreatic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver 3-segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47144","description":"Prep donor liver 3-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9884","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA1","description":"ICD-KISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA0","description":"ICD-NKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE1","description":"ICD-FAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC0","description":"ICD-OJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/replace penis prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54410","description":"Remove/replace penis prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF0","description":"ICD-JFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0804","description":"HCPCS-A0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig rna no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8460","description":"Pt inelig rna no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB31","description":"ICD-2DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF0","description":"ICD-FBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01486","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","description":"CPT-01486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC0","description":"ICD-FDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2011","description":"Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g._ audit_ DAST)_ and brief intervention_ 5-14 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB1","description":"ICD-KCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX11","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av fusion direct any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36821","description":"Av fusion direct any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58760","description":"Fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA255","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD0","description":"ICD-JCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0137U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imuglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1786","description":"Imuglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5655","description":"Socket insert below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5242","description":"Hearing aid_ monaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC1","description":"ICD-NKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE0","description":"ICD-EDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF0","description":"ICD-JBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA1","description":"ICD-FHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF1","description":"ICD-KBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB0","description":"ICD-JCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD0","description":"ICD-PFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1004","description":"HCPCS-A1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA0","description":"ICD-EEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF0","description":"ICD-NJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC115","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay blood catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82383","description":"Assay blood catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA204","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID0","description":"ICD-JBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA0","description":"ICD-NAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endo not barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3141F","description":"Upper gi endo not barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4C","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2402","description":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF1","description":"ICD-BICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermacell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4122","description":"Dermacell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cltx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27760","description":"Cltx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB1","description":"ICD-KIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC121","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB1","description":"ICD-FCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cer post col occ/man sup adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0180","description":"Cer post col occ/man sup adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA1","description":"ICD-IHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB0","description":"ICD-DDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95714","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD1","description":"ICD-FGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25645","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30140","description":"Resect inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood collection tube/vacuum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4770","description":"Blood collection tube/vacuum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC0","description":"ICD-CCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC0","description":"ICD-JACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE1","description":"ICD-NLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE1","description":"ICD-LBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spun microhematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85013","description":"Spun microhematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0483T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33958","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72195","description":"MRI pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD0","description":"ICD-FAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0167U","description":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF0","description":"ICD-CHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15136","description":"Derm autograft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF0","description":"ICD-AEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crotalidae poly immune fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0840","description":"Crotalidae poly immune fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND1","description":"ICD-NFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93587","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA0","description":"ICD-PHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF1","description":"ICD-OGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA02","description":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB1","description":"ICD-HCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB0","description":"ICD-BDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9080","description":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC0","description":"ICD-GDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid peri/retro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49406","description":"Image cath fluid peri/retro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB01","description":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE0","description":"ICD-FIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB1","description":"ICD-MIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strep b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87653","description":"Strep b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB0","description":"ICD-ECHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens gas permeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2531","description":"Contact lens gas permeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral axial decompressio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9090","description":"Vertebral axial decompressio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF1","description":"ICD-CIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC1","description":"ICD-JEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD1","description":"ICD-GFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ground mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0425","description":"Ground mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6214","description":"Foam drg > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ac5 advanced wound system (ac5)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2020","description":"Ac5 advanced wound system (ac5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tocilizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3262","description":"Tocilizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Man w/c push-rim powr system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0986","description":"Man w/c push-rim powr system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF1","description":"ICD-IFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB1","description":"ICD-HHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of choroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67220","description":"Treatment of choroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA0","description":"ICD-OCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC0","description":"ICD-ADEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0612","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD0","description":"ICD-FCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0571U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","description":"CPT-0571U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD1","description":"ICD-OEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 3/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80322","description":"Alcohols biomarkers 3/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sex transformation f to m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55980","description":"Sex transformation f to m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD0","description":"ICD-OJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD0","description":"ICD-BBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3976","description":"Sewhfo airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rimantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9020","description":"Rimantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC1","description":"ICD-BFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB1","description":"ICD-CCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA1","description":"ICD-PIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD0","description":"ICD-GAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF1","description":"ICD-IICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD0","description":"ICD-MCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24515","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC0","description":"ICD-GHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA1","description":"ICD-FIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC0","description":"ICD-OJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB0","description":"ICD-GGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","description":"HCPCS-M1419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE1","description":"ICD-NIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF0","description":"ICD-GGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF0","description":"ICD-GINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB1","description":"ICD-CHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70110","description":"X-ray exam of jaw 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA11","description":"ICD-3IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME1","description":"ICD-GAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC1","description":"ICD-GFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE0","description":"ICD-EEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA0","description":"ICD-HEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA0","description":"ICD-OGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE0","description":"ICD-GCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetone assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82010","description":"Acetone assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special reports or forms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99080","description":"Special reports or forms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE1","description":"ICD-KEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92986","description":"Revision of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9991","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD1","description":"ICD-IEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND1","description":"ICD-OFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87449","description":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD0","description":"ICD-MDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9369","description":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"LW GNOTYP ICAM4 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0197U","description":"LW GNOTYP ICAM4 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA0","description":"ICD-CHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB0","description":"ICD-AATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0147U","description":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound pouch each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6154","description":"Wound pouch each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB0","description":"ICD-FCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0492T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE0","description":"ICD-NHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF0","description":"ICD-OERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA50","description":"High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC1","description":"ICD-BCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD1","description":"ICD-MCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA1","description":"ICD-GFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA0","description":"ICD-MJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF1","description":"ICD-OFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD0","description":"ICD-NDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temp anchorage dev w flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7293","description":"Temp anchorage dev w flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tympanometry & reflex thresh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92550","description":"Tympanometry & reflex thresh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC0","description":"ICD-KFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pulmonary shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33924","description":"Remove pulmonary shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA0","description":"ICD-IHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC0","description":"ICD-PLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF0","description":"ICD-IFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antibody slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88344","description":"Immunohisto antibody slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin/1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0725","description":"Chorionic gonadotropin/1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42405","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15832","description":"Excise excessive skin thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE0","description":"ICD-NKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5158","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","description":"HCPCS-Q5158","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath place cardio brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92974","description":"Cath place cardio brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2082","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE0","description":"ICD-OKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE1","description":"ICD-FAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9682","description":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA0","description":"ICD-NHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE1","description":"ICD-ODRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroconvulsive therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90870","description":"Electroconvulsive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC1","description":"ICD-NCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD0","description":"ICD-EADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","description":"CPT-00400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA1","description":"ICD-KFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC0","description":"ICD-NCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF0","description":"ICD-OEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA1","description":"ICD-ODCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal duct glbldr calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47544","description":"Removal duct glbldr calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE1","description":"ICD-GFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asthma education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9441","description":"Asthma education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA1","description":"ICD-KIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID1","description":"ICD-KBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45303","description":"Proctosigmoidoscopy dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD0","description":"ICD-GDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE1","description":"ICD-IIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"American amnion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4307","description":"American amnion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF0","description":"ICD-MADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11600","description":"Exc tr-ext mal+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB0","description":"ICD-OGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF0","description":"ICD-FECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB0","description":"ICD-OECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 5MCG/.5ML AS03B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104A","description":"ADM SARSCOV2 5MCG/.5ML AS03B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE1","description":"ICD-FEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5938","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5938","description":"CDT-D5938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibio rx w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9286","description":"Antibio rx w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth genitalia surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92051","description":"Anesth genitalia surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF0","description":"ICD-MHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB1","description":"ICD-MATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE0","description":"ICD-KABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC1","description":"ICD-OCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB1","description":"ICD-CIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML06","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD1","description":"ICD-IAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96365","description":"Ther/proph/diag iv inf init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC0","description":"ICD-OISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC0","description":"ICD-BIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01680","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","description":"CPT-01680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 45 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90836","description":"Psytx pt&/fam w/e&m 45 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF0","description":"ICD-JEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72142","description":"MRI neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97606","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA1","description":"ICD-PEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9726","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trcath replace aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33366","description":"Trcath replace aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC1","description":"ICD-GCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD1","description":"ICD-OFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE0","description":"ICD-GIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB1","description":"ICD-CITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME1","description":"ICD-ODME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID1","description":"ICD-NEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042U","description":"Borrelia burgdorferi_ antibody detection of 12 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC1","description":"ICD-BCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF1","description":"ICD-KGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0927T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","description":"CPT-0927T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD1","description":"ICD-BFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC0","description":"ICD-NHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED1","description":"ICD-GAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF0","description":"ICD-LFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE0","description":"ICD-KGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv syst funj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95923","description":"Autonomic nrv syst funj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE0","description":"ICD-OFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total cortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82533","description":"Total cortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE0","description":"ICD-KCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Agglutinins febrile antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86000","description":"Agglutinins febrile antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5962","description":"Below knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown full noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6792","description":"Crown full noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB135","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8577","description":"Reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC0","description":"ICD-ADAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC0","description":"ICD-EFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE1","description":"ICD-OBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1032T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1032T","description":"CPT-1032T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48520","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE0","description":"ICD-PEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD1","description":"ICD-OCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE1","description":"ICD-JEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE0","description":"ICD-GGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inebilizumab-cdon_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1823","description":"Injection_ inebilizumab-cdon_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust knee ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1810","description":"Adjust knee ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB114","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID1","description":"ICD-BEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB0","description":"ICD-AHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8X","description":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic eye other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2629","description":"Prosthetic eye other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA0","description":"ICD-FHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD1","description":"ICD-EADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE0","description":"ICD-GAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC0","description":"ICD-NBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF1","description":"ICD-NATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29883","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE1","description":"ICD-NBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artificial larynx_ accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8505","description":"Artificial larynx_ accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF1","description":"ICD-IBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE1","description":"ICD-FHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF1","description":"ICD-GIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED1","description":"ICD-JBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF1","description":"ICD-GBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF1","description":"ICD-LEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5988","description":"Surgical splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE0","description":"ICD-PAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB0","description":"ICD-EFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD0","description":"ICD-GCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride genitalia & perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11004","description":"Debride genitalia & perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE1","description":"ICD-LHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lg vol nebulizer disposable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7007","description":"Lg vol nebulizer disposable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF1","description":"ICD-ADEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pouch drain high output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4412","description":"Ost pouch drain high output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE1","description":"ICD-OFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD0","description":"ICD-IDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37281","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","description":"CPT-37281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC0","description":"ICD-MBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68750","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20932","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC1","description":"ICD-NLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA0","description":"ICD-KIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fndngs mammo 2pt w/in 3 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5060F","description":"Fndngs mammo 2pt w/in 3 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC22","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF0","description":"ICD-NLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA1","description":"ICD-CIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin splt grft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15101","description":"Skin splt grft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC1","description":"ICD-CHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-serv of ot_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0152","description":"Hhcp-serv of ot_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25441","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD1","description":"ICD-GHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted for performance of elective carotid intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9689","description":"Patient admitted for performance of elective carotid intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB0","description":"ICD-JFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg pres wound ther drsg set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6550","description":"Neg pres wound ther drsg set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caspofungin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0637","description":"Caspofungin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB221","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25075","description":"Exc forearm les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE140","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytomegalovirus imm iv /vial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0850","description":"Cytomegalovirus imm iv /vial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB0","description":"ICD-KELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no scr uter malig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9619","description":"Doc rsn no scr uter malig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flebogamma injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1572","description":"Flebogamma injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81539","description":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB0","description":"ICD-KDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC1","description":"ICD-ABCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA1","description":"ICD-BBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA0","description":"ICD-CCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD0","description":"ICD-AGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC1","description":"ICD-JDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD0","description":"ICD-KGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"100 insulin syringes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8490","description":"100 insulin syringes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB205","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA1","description":"ICD-OIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7681","description":"Terbutaline sulf comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC0","description":"ICD-OFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC1","description":"ICD-FDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth one lung ventilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54151","description":"Anesth one lung ventilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone acetate_ per 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1095","description":"Injection_ dexamethasone acetate_ per 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","description":"HCPCS-J9024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE0","description":"ICD-JBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE0","description":"ICD-OCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME0","description":"ICD-EHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB1","description":"ICD-DCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval self-assess depression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3005","description":"Eval self-assess depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93041","description":"Rhythm ecg tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB0","description":"ICD-BHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE1","description":"ICD-KBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC0","description":"ICD-OKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF0","description":"ICD-JHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE0","description":"ICD-MHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA1","description":"ICD-CFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC1","description":"ICD-MKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE204","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97760","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented below normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1287","description":"Bmi is documented below normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam 4 or > surfaces perm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2161","description":"Amalgam 4 or > surfaces perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA0","description":"ICD-LBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp cont lens eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0592","description":"Comp cont lens eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA1","description":"ICD-CHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl >/= 13 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3279F","description":"Hgb lvl >/= 13 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0162U","description":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Womans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3224","description":"Womans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC0","description":"ICD-NKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corticoster sparng thrpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4142F","description":"Corticoster sparng thrpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01390","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","description":"CPT-01390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA105","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78185","description":"Spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD1","description":"ICD-GIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC1","description":"ICD-JGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND0","description":"ICD-KDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB1","description":"ICD-AFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC226","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caster pin lock each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0073","description":"Caster pin lock each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62291","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC0","description":"ICD-OLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD1","description":"ICD-CDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF0","description":"ICD-GFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC1","description":"ICD-ODQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC0","description":"ICD-CBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35450","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF0","description":"ICD-BBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9269","description":"Doc no comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD1","description":"ICD-FFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE1","description":"ICD-BFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB1","description":"ICD-AFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures immediat maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5130","description":"Dentures immediat maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","description":"CPT-01484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37263","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","description":"CPT-37263","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7023","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF1","description":"ICD-BCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL25","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61304","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE1","description":"ICD-EFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD0","description":"ICD-KFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC1","description":"ICD-NKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB0","description":"ICD-KDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB1","description":"ICD-CIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth blood vessel repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77051","description":"Anesth blood vessel repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metal frame recipro hip & ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2628","description":"Metal frame recipro hip & ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF1","description":"ICD-FBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc abdm/per/oment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49329","description":"Laparo proc abdm/per/oment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD1","description":"ICD-EDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alveoloplasty w/extract 1-3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7311","description":"Alveoloplasty w/extract 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC1","description":"ICD-JHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA0","description":"ICD-IDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB30","description":"Very High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15956","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pjp proph ordered cd4 low","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9223","description":"Pjp proph ordered cd4 low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD0","description":"ICD-DGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented within normal parameters and no follow-up plan is required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1296","description":"Bmi is documented within normal parameters and no follow-up plan is required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF1","description":"ICD-NDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA31","description":"ICD-3JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB1","description":"ICD-CCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given vte prophylx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4044F","description":"Doc order given vte prophylx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC1","description":"ICD-JIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE1","description":"ICD-KBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1805","description":"Injection_ esmolol hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE256","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF0","description":"ICD-AFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC0","description":"ICD-KGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA1","description":"ICD-ICHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92851","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE1","description":"ICD-BEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC117","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC0","description":"ICD-CITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72125","description":"Ct neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alysishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88369","description":"M/phmtrc alysishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD0","description":"ICD-MEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41500","description":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE1","description":"ICD-GDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF0","description":"ICD-JECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0547","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","description":"HCPCS-G0547","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3917","description":"Metacarp fx orthosis pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF0","description":"ICD-CIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE0","description":"ICD-NJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA1","description":"ICD-EHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA0","description":"ICD-GHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE1","description":"ICD-KDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of tibia nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28035","description":"Decompression of tibia nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paclitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9267","description":"Paclitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD0","description":"ICD-CAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rpl car modulj pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414T","description":"Rmvl & rpl car modulj pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB1","description":"ICD-NJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF0","description":"ICD-NFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluvirin vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2037","description":"Fluvirin vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF0","description":"ICD-NLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8692","description":"Replacement retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA33","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No scr utr malig/us/samp rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9620","description":"No scr utr malig/us/samp rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC0","description":"ICD-OCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma hmes filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7504","description":"Tracheostoma hmes filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD0","description":"ICD-OBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC0","description":"ICD-FCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF0","description":"ICD-IEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC0","description":"ICD-CGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE1","description":"ICD-OFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA1","description":"ICD-AFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj beta interferon im 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3027","description":"Inj beta interferon im 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME1","description":"ICD-IGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB0","description":"ICD-GBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA1","description":"ICD-FFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF0","description":"ICD-JFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB0","description":"ICD-BIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81360","description":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD1","description":"ICD-CFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE0","description":"ICD-CGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE0","description":"ICD-MICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4271F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE1","description":"ICD-HBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA0","description":"ICD-KGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9056","description":"Injection_ givosiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta-blocker therapy rxd/tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4008F","description":"Beta-blocker therapy rxd/tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF0","description":"ICD-DAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c manual swingaway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1028","description":"W/c manual swingaway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA0","description":"ICD-GAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op asst not doc_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9617","description":"Pre-op asst not doc_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC1","description":"ICD-CENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC21","description":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB0","description":"ICD-JFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9142","description":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minocycline hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2265","description":"Minocycline hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC0","description":"ICD-GGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC1","description":"ICD-CEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artacent AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4190","description":"Artacent AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC0","description":"ICD-IDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0502","description":"HCPCS-B0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB1","description":"ICD-CHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD1","description":"ICD-CIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC1","description":"ICD-JHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA1","description":"ICD-GHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4341","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF1","description":"ICD-CIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD0","description":"ICD-NALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4C","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD1","description":"ICD-FFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ovine_ up to 999 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3471","description":"Ovine_ up to 999 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA0","description":"ICD-BBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulp cap indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3120","description":"Pulp cap indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD0","description":"ICD-CIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE0","description":"ICD-NDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE0","description":"ICD-IFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36901","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA1","description":"ICD-MEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC0","description":"ICD-NIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stgi no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9063","description":"Onc dx nsclc stgi no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD0","description":"ICD-FIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF1","description":"ICD-LCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB1","description":"ICD-JDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm receiver_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5287","description":"Ald fm/dm receiver_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1403","description":"HCPCS-C1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35884","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD1","description":"ICD-MLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF1","description":"ICD-CHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA0","description":"ICD-LGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC0","description":"ICD-CGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA120","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86362","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE0","description":"ICD-GGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electron elbow adolescent sw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7185","description":"Electron elbow adolescent sw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE0","description":"ICD-MCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36254","description":"Ins cath ren art 2nd+ bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC1","description":"ICD-GHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA0","description":"ICD-KISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB0","description":"ICD-JHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA0","description":"ICD-PKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biovance tri-layer or biovance 3l_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4283","description":"Biovance tri-layer or biovance 3l_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (focinvez)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1434","description":"Injection_ fosaprepitant (focinvez)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meals per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9977","description":"Meals per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE1","description":"ICD-JBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of somatomedin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84305","description":"Assay of somatomedin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB0","description":"ICD-KAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA0","description":"ICD-EEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC0","description":"ICD-CGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB1","description":"ICD-BHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA1","description":"ICD-OIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csf leakage imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78650","description":"Csf leakage imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9895","description":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD212","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0678U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678U","description":"CPT-0678U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC0","description":"ICD-NHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","description":"CPT-55712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA1","description":"ICD-KFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB0","description":"ICD-BEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81552","description":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5648","description":"Above knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 3-5 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87631","description":"Resp virus 3-5 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF0","description":"ICD-GIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD1","description":"ICD-OKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88342","description":"Immunohisto antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB1","description":"ICD-AAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC1","description":"ICD-CIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv collar supp adj cerv ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0190","description":"Cerv collar supp adj cerv ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD1","description":"ICD-KCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME0","description":"ICD-ADME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF1","description":"ICD-JFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB1","description":"ICD-KBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst w/t/o compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58554","description":"Laparo-vag hyst w/t/o compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE0","description":"ICD-GAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography thoracic spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72255","description":"Myelography thoracic spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD0","description":"ICD-GCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF0","description":"ICD-DHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB0","description":"ICD-FILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49566","description":"Rerepair ventrl hern block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB1","description":"ICD-NAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 32 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2267","description":"Induced abortion 32 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0033U","description":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB0","description":"ICD-CCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","description":"HCPCS-M1394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF0","description":"ICD-HCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432U","description":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF1","description":"ICD-MAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2046","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2046","description":"HCPCS-A2046","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC1","description":"ICD-GCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41009","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87485","description":"Chylmd pneum dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27620","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89356","description":"Thawing cryopresrved oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral antiplat thx rx dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4073F","description":"Oral antiplat thx rx dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC0","description":"ICD-IDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE0","description":"ICD-GEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA1","description":"ICD-NBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD1","description":"ICD-JGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61642","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62121","description":"Incise skull repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0170","description":"Commode chair electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD1","description":"ICD-DGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nandrolone decanoate 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2320","description":"Nandrolone decanoate 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF0","description":"ICD-GGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA14","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2149","description":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA0","description":"ICD-CDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD0","description":"ICD-FADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc viral load <200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9243","description":"Doc viral load <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD0","description":"ICD-NJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exposure impact tooth orthod","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7280","description":"Exposure impact tooth orthod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB1","description":"ICD-KDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB0","description":"ICD-MECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD0","description":"ICD-MAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 3 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2663","description":"Dental onlay resin 3 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay >= 3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6605","description":"Cst bse mtl inlay >= 3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF1","description":"ICD-JFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vesiculobullous disease carr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5991","description":"Vesiculobullous disease carr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community-acquired bacterial pneumonia assessment (includes all of the foll","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0118U","description":"Community-acquired bacterial pneumonia assessment (includes all of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF1","description":"ICD-ACEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE116","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB0","description":"ICD-PGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA0","description":"ICD-OLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gamma globulin 1 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1460","description":"Gamma globulin 1 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation by ocularist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9150","description":"Evaluation by ocularist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD1","description":"ICD-MKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compact travel hemodialyzer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1635","description":"Compact travel hemodialyzer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD121","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm antibody test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89325","description":"Sperm antibody test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63091","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gravity assisted traction de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0941","description":"Gravity assisted traction de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD1","description":"ICD-NHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE1","description":"ICD-GIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of adrenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86651","description":"Anesth removal of adrenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF1","description":"ICD-CBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB1","description":"ICD-OILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"New lenses in pts old frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0595","description":"New lenses in pts old frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20560","description":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9698","description":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19000","description":"Drainage of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF0","description":"ICD-HGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9283","description":"Hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA0","description":"ICD-NJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25924","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0656U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0656U","description":"CPT-0656U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD1","description":"ICD-GHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lrh hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83727","description":"Assay of lrh hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instll rx agnt into rnal tub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50391","description":"Instll rx agnt into rnal tub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB1","description":"ICD-JDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA0","description":"ICD-GDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xcell amnio matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4280","description":"Xcell amnio matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC0","description":"ICD-BHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rsa upper extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349T","description":"Rsa upper extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8941","description":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent hemoglobin a1c level > 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1211","description":"Most recent hemoglobin a1c level > 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC1","description":"ICD-BFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA1","description":"ICD-DHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC0","description":"ICD-AECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA1","description":"ICD-OBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE1","description":"ICD-DBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42400","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC1","description":"ICD-KCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69641","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thi/glut/ischia wgt bearing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2500","description":"Thi/glut/ischia wgt bearing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51575","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC0","description":"ICD-KICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE1","description":"ICD-JFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9816","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9816","description":"HCPCS-C9816","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB21","description":"ICD-3LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flulaval vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2036","description":"Flulaval vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC0","description":"ICD-OAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt w cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9240","description":"Doc pt w cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin tx mdd not comm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8960","description":"Clin tx mdd not comm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA0","description":"ICD-GGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ergonovine maleate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1330","description":"Ergonovine maleate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft head/neck >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64886","description":"Nerve graft head/neck >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB0","description":"ICD-LDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forearm crutch platform atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0153","description":"Forearm crutch platform atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB0","description":"ICD-CDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt not on statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9508","description":"Doc pt not on statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA1","description":"ICD-DDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME0","description":"ICD-GGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD1","description":"ICD-MHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB0","description":"ICD-JDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB0","description":"ICD-GFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE0","description":"ICD-GHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB0","description":"ICD-LIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of manganese","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83785","description":"Assay of manganese","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27227","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA1","description":"ICD-OHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF1","description":"ICD-PLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA1","description":"ICD-OAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND1","description":"ICD-FAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0135U","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75870","description":"Vein x-ray skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA0","description":"ICD-CHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD235","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD0","description":"ICD-PDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp carotid-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35606","description":"Art byp carotid-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF0","description":"ICD-EBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB1","description":"ICD-BEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72141","description":"MRI neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28302","description":"Incision of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB1","description":"ICD-OLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND0","description":"ICD-CIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB0","description":"ICD-MDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close tear system fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68770","description":"Close tear system fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE0","description":"ICD-HCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0588T","description":"Revision Or Removal Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Programming_ And Imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20665","description":"Removal of fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC52","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB0","description":"ICD-ACEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE0","description":"ICD-GIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB114","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45332","description":"Sigmoidoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF1","description":"ICD-IGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF1","description":"ICD-NETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tibiofibular joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27871","description":"Fusion of tibiofibular joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9051","description":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reusable underpad chair size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4540","description":"Reusable underpad chair size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC31","description":"ICD-4HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD1","description":"ICD-MAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC1","description":"ICD-AFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB0","description":"ICD-BACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB1","description":"ICD-CBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD0","description":"ICD-KHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB0","description":"ICD-AFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA0","description":"ICD-GAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC1","description":"ICD-NLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE0","description":"ICD-NGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID0","description":"ICD-MBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86880","description":"Coombs test direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk thigh lacer non-molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5680","description":"Bk thigh lacer non-molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID1","description":"ICD-GEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB1","description":"ICD-BIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA1","description":"ICD-ADCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace denture teeth complt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5520","description":"Replace denture teeth complt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96119","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem endovas vena cava filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37193","description":"Rem endovas vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23800","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD0","description":"ICD-BHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE0","description":"ICD-FGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27686","description":"Revise lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65112","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pasrr level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2011","description":"Pasrr level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1054T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1054T","description":"CPT-1054T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appliance cleaner","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5131","description":"Appliance cleaner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","description":"CPT-00632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8C","description":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68761","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vc lesion w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31545","description":"Remove vc lesion w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB0","description":"ICD-NKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63661","description":"Remove spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD0","description":"ICD-JHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF0","description":"ICD-FADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE0","description":"ICD-DHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb laminated socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5540","description":"Prep bk ptb laminated socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tx decision-mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9051","description":"Oncology tx decision-mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Middle cerebral artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76821","description":"Middle cerebral artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD0","description":"ICD-OGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1pc ost pch drain hgh output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4435","description":"1pc ost pch drain hgh output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74181","description":"MRI abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn no comm comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9232","description":"Docrsn no comm comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA0","description":"ICD-AFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","description":"CPT-90382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bone lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21025","description":"Excision of bone lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61888","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36200","description":"Place catheter in aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20939","description":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cleft palate repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17251","description":"Anesth cleft palate repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA1","description":"ICD-IHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF1","description":"ICD-OEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA0","description":"ICD-BCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1170","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wireless pressure sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2624","description":"Wireless pressure sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB0","description":"ICD-AGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0653U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0653U","description":"CPT-0653U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29365","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ breast_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8908","description":"MRI w/o fol w/cont_ breast_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE1","description":"ICD-DIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC1","description":"ICD-GFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB0","description":"ICD-BDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drop lock knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2182","description":"Drop lock knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68335","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj lo_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9004","description":"Mccd_ risk adj lo_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76826","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC1","description":"ICD-BDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC1","description":"ICD-OFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA0","description":"ICD-OCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum over 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49204","description":"Exc abd tum over 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95705","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB21","description":"ICD-3GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1194","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE1","description":"ICD-OHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB1","description":"ICD-KIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/ tc 1 marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88184","description":"Flowcytometry/ tc 1 marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF1","description":"ICD-HDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC44","description":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB1","description":"ICD-GBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC0","description":"ICD-FGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF0","description":"ICD-CIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA1","description":"ICD-KFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA0","description":"ICD-AATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE1","description":"ICD-NJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2000F","description":"Blood pressure measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36015","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0999T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","description":"CPT-0999T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak/ft power asst incl motors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5969","description":"Ak/ft power asst incl motors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0024","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE0","description":"ICD-HAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364U","description":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC0","description":"ICD-FBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9045","description":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5B","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC0","description":"ICD-BBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31600","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF1","description":"ICD-GHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC0","description":"ICD-KAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC11","description":"ICD-4FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67039","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"U1 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2365","description":"U1 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72149","description":"MRI lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92082","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF1","description":"ICD-AHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD1","description":"ICD-LFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC1","description":"ICD-MFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB1","description":"ICD-KBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2520","description":"Dental inlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB1","description":"ICD-MBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB204","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert w lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5673","description":"Socket insert w lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC1","description":"ICD-KAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD1","description":"ICD-GCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergy patch tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95044","description":"Allergy patch tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016M","description":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ippb all types","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0500","description":"Ippb all types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Micro exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0473","description":"Micro exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF1","description":"ICD-JHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF0","description":"ICD-NETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA1","description":"ICD-LAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC1","description":"ICD-CFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE1","description":"ICD-JEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD0","description":"ICD-JGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD1","description":"ICD-KIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF0","description":"ICD-MFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE1","description":"ICD-JCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC0","description":"ICD-MHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69300","description":"Revise external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA0","description":"ICD-CFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove renal tube w/fluoro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50389","description":"Remove renal tube w/fluoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0434","description":"Portable liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD1","description":"ICD-BDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE0","description":"ICD-NLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB1","description":"ICD-PCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audit/dast 15-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99408","description":"Audit/dast 15-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF1","description":"ICD-KGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE0","description":"ICD-CBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0852T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE1","description":"ICD-IDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart image spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78494","description":"Heart image spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF0","description":"ICD-FGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB1","description":"ICD-DEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB55","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1852","description":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87513","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","description":"CPT-87513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB1","description":"ICD-DDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC0","description":"ICD-BIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus ivntj perph les","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31654","description":"Bronch ebus ivntj perph les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86698","description":"Histoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD1","description":"ICD-AFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD0","description":"ICD-BCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trichomonas vaginalis amplif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87661","description":"Trichomonas vaginalis amplif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99347","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nesiritide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2325","description":"Nesiritide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE150","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD1","description":"ICD-OJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE0","description":"ICD-BCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC0","description":"ICD-NIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0636T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculation tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87252","description":"Virus inoculation tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA1","description":"ICD-IFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD1","description":"ICD-NHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA0","description":"ICD-FAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9984","description":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA0","description":"ICD-CGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB1","description":"ICD-IADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE0","description":"ICD-IIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA0","description":"ICD-AECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50045","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc back les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21931","description":"Exc back les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6509","description":"Compres burn garment jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD0","description":"ICD-CISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA0","description":"ICD-DBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF1","description":"ICD-CCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB0","description":"ICD-GDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF1","description":"ICD-HFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA1","description":"ICD-JCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1452","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","description":"HCPCS-M1452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1015","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF1","description":"ICD-NAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical food oral 100% nutr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9433","description":"Medical food oral 100% nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA1","description":"ICD-JHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME0","description":"ICD-NIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC0","description":"ICD-FHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE1","description":"ICD-GISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2080","description":"Laup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0401","description":"CDT-D0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE1","description":"ICD-MJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fungus isolation culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87102","description":"Fungus isolation culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen(s) test for platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9100","description":"Pathogen(s) test for platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28322","description":"Repair of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42836","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6257","description":"Transparent film <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19297","description":"Place breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0097U","description":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA1","description":"ICD-JICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amines vaginal fluid qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82120","description":"Amines vaginal fluid qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD1","description":"ICD-NLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB0","description":"ICD-FEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Str markers specimen anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81265","description":"Str markers specimen anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA0","description":"ICD-BCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyrotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3240","description":"Thyrotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE1","description":"ICD-MGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE1","description":"ICD-EHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB0","description":"ICD-JBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67440","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA1","description":"ICD-JEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment Career Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1732","description":"Employment Career Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC0","description":"ICD-AEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468U","description":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA1","description":"ICD-FBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder stone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87051","description":"Anesth bladder stone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3472","description":"Surgical repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apnea monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0618","description":"Apnea monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB0","description":"ICD-CGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC0","description":"ICD-OJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD1","description":"ICD-OKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Barium swallow test ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3142F","description":"Barium swallow test ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In111 satumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4642","description":"In111 satumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE0","description":"ICD-CCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column adl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22208","description":"Incis spine 3 column adl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB0","description":"ICD-EHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23450","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA1","description":"ICD-OALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF0","description":"ICD-JFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1832","description":"Ko adj jnt pos r sup pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE0","description":"ICD-GBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD0","description":"ICD-FHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA0","description":"ICD-PFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA0","description":"ICD-NJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC1","description":"ICD-MHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9164","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45305","description":"Proctosigmoidoscopy w/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB11","description":"ICD-2DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Choline C 11_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9461","description":"Choline C 11_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9789","description":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Io rad tx deliver by elctrns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77425","description":"Io rad tx deliver by elctrns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD0","description":"ICD-FCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD1","description":"ICD-PKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE0","description":"ICD-CBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21261","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hmatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4134","description":"Hmatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD1","description":"ICD-CHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8G","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD1","description":"ICD-OAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE0","description":"ICD-GDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF0","description":"ICD-OEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA1","description":"ICD-HHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00851","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","description":"CPT-00851","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE0","description":"ICD-CITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME0","description":"ICD-OAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC0","description":"ICD-FHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD0","description":"ICD-MHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1321","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe sole wedge between sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3370","description":"Shoe sole wedge between sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF0","description":"ICD-BFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9323","description":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi den insert direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5512","description":"Multi den insert direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE121","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8G","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA1","description":"ICD-AAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg dev eval impltbl sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93260","description":"Prgrmg dev eval impltbl sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5701","description":"Replace socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD0","description":"ICD-NETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC231","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD1","description":"ICD-FBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA45","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of figure eight","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29049","description":"Application of figure eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA30","description":"Very High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE1","description":"ICD-CIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","description":"HCPCS-G0563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artacent cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4216","description":"Artacent cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1903","description":"HCPCS-B1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":">=50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1007","description":">=50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket hip disarticulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5626","description":"Test socket hip disarticulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB1","description":"ICD-AEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB0","description":"ICD-CELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD1","description":"ICD-BEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","description":"CPT-01940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35121","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC1","description":"ICD-OLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF0","description":"ICD-MLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE1","description":"ICD-KDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic graft facial bones","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7995","description":"Synthetic graft facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB1","description":"ICD-BAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF0","description":"ICD-MCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF1","description":"ICD-BGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB1","description":"ICD-OAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC0","description":"ICD-FDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81439","description":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF1","description":"ICD-OAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9940","description":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57289","description":"Repair bladder & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA1","description":"ICD-BEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE1","description":"ICD-NFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE1","description":"ICD-NFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9377","description":"Hit hydra over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9741","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB1","description":"ICD-BCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD0","description":"ICD-CDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC1","description":"ICD-GHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93641","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME1","description":"ICD-BGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB0","description":"ICD-EDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Service Coordination**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1011","description":"Service Coordination**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD255","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anal tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46230","description":"Removal of anal tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC1","description":"ICD-KIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Including Rib(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21601","description":"Excision Of Chest Wall Tumor Including Rib(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD0","description":"ICD-HCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB1","description":"ICD-OKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE1","description":"ICD-PLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE1","description":"ICD-NIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levofloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1956","description":"Levofloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8002","description":"HCPCS-C8002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc mel cnr stg 0 - iic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8944","description":"Ajcc mel cnr stg 0 - iic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC0","description":"ICD-BGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF1","description":"ICD-GDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF0","description":"ICD-PKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB0","description":"ICD-GBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404U","description":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA36","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adoptive immunotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2107","description":"Adoptive immunotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE1","description":"ICD-BBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA0","description":"ICD-HEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD114","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD1","description":"ICD-OEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME0","description":"ICD-MJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE0","description":"ICD-ABTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74410","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA0","description":"ICD-GDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC1","description":"ICD-GFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB0","description":"ICD-BITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD150","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0495U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","description":"CPT-0495U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA0","description":"ICD-KHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF1","description":"ICD-AAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC0","description":"ICD-KFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32225","description":"Partial release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No rec cortico>60d 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9470","description":"No rec cortico>60d 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA0","description":"ICD-CCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA0","description":"ICD-OFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND0","description":"ICD-CAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB1","description":"ICD-GCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA55","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD0","description":"ICD-BEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Reusable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4436","description":"Irrigation Supply; Sleeve_ Reusable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58974","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC1","description":"ICD-BCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid seat support base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2231","description":"Solid seat support base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal vestibular lateral wall stenosis with implant(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9749","description":"Repair of nasal vestibular lateral wall stenosis with implant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA0","description":"ICD-HCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE0","description":"ICD-ACHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD1","description":"ICD-IEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB0","description":"ICD-OAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA0","description":"ICD-GEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2298","description":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio spine w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72159","description":"Mr angio spine w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD1","description":"ICD-KGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC0","description":"ICD-NLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE1","description":"ICD-JEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33335","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB1","description":"ICD-NBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9057","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB0","description":"ICD-DHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","description":"CPT-00942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0777T","description":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD1","description":"ICD-MHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD1","description":"ICD-PLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD1","description":"ICD-BHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87650","description":"Strep a dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF0","description":"ICD-JGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND1","description":"ICD-JBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE1","description":"ICD-EATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA0","description":"ICD-NLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD231","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC0","description":"ICD-GGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc of pain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8732","description":"No doc of pain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF0","description":"ICD-LHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/.12-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2303","description":"Lens sphcy trifocal 4.0/.12-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA0","description":"ICD-BDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1001","description":"HCPCS-A1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC0","description":"ICD-JEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA1","description":"ICD-NJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traction stand free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0850","description":"Traction stand free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE0","description":"ICD-BAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD0","description":"ICD-KAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB0","description":"ICD-GGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC244","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA0","description":"ICD-HCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC1","description":"ICD-MBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB0","description":"ICD-ACDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6003","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA1","description":"ICD-MGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF0","description":"ICD-KFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB1","description":"ICD-BGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB0","description":"ICD-BIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE0","description":"ICD-ODOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4043F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC1","description":"ICD-OASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg awake and drowsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95816","description":"Eeg awake and drowsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF1","description":"ICD-CCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construct bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51980","description":"Construct bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61700","description":"Brain aneurysm repr simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD0","description":"ICD-AGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID1","description":"ICD-IGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE0","description":"ICD-FGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES105","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA1","description":"ICD-OAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperbaric oxygen therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99183","description":"Hyperbaric oxygen therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF0","description":"ICD-AGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31785","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9993","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36217","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC0","description":"ICD-CERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50234","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23505","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1201","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF0","description":"ICD-ADMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analys amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88269","description":"Chromosome analys amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic single inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64461","description":"Pvb thoracic single inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0672","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0672","description":"HCPCS-G0672","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap gastr bypass incl smll i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43645","description":"Lap gastr bypass incl smll i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF1","description":"ICD-KHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF0","description":"ICD-CEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA1","description":"ICD-NLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA1","description":"ICD-NIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA1","description":"ICD-ADBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc sinus ct 28d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9349","description":"Doc sinus ct 28d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63197","description":"Incise spine&cord 2 trx thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent urinary cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4353","description":"Intermittent urinary cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF0","description":"ICD-GICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA17","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso infant immobilizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1001","description":"Ctlso infant immobilizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1166","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD1","description":"ICD-KBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD1","description":"ICD-PGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB1","description":"ICD-ODFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE1","description":"ICD-JCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF0","description":"ICD-FEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped dynamic seating frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2295","description":"Ped dynamic seating frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4523","description":"Adult size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA0","description":"ICD-NDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21193","description":"Reconst lwr jaw w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molecular testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0606","description":"Molecular testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oth resp proc_ indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0238","description":"Oth resp proc_ indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9766","description":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ metronidazole_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1836","description":"Injection_ metronidazole_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sitz bath chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0162","description":"Sitz bath chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC0","description":"ICD-ICMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD0","description":"ICD-BFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA0","description":"ICD-AGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tinzaparin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1655","description":"Tinzaparin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr nuclear antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86664","description":"Epstein-barr nuclear antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB225","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD0","description":"ICD-MLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA0","description":"ICD-JDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE0","description":"ICD-AFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB0","description":"ICD-OIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB155","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA0","description":"ICD-NGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD0","description":"ICD-BGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant breast silicone/eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8600","description":"Implant breast silicone/eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE1","description":"ICD-CCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct sft tsue nck w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70492","description":"Ct sft tsue nck w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intestine transplnt cadaver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44135","description":"Intestine transplnt cadaver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA0","description":"ICD-OJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Baclofen 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0475","description":"Baclofen 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE1","description":"ICD-JBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE1","description":"ICD-GCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE106","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27041","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81325","description":"Pmp22 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelet pheresis irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9036","description":"Platelet pheresis irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF1","description":"ICD-HGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC0","description":"ICD-JIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm/icd remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93296","description":"Pm/icd remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE0","description":"ICD-CHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess hlth/behave init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96150","description":"Assess hlth/behave init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27357","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML26","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB0","description":"ICD-OBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rotator cuff acute","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23410","description":"Repair rotator cuff acute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES335","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral speech device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92597","description":"Oral speech device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE1","description":"ICD-NHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC1","description":"ICD-OEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35881","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE204","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eptifibatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1327","description":"Eptifibatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB1","description":"ICD-BEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool Tub_ Walk-In_ Portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1003","description":"Whirlpool Tub_ Walk-In_ Portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE0","description":"ICD-KHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC0","description":"ICD-KHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC0","description":"ICD-KHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62305","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immune globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90399","description":"Immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC0","description":"ICD-OHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE1","description":"ICD-GIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE1","description":"ICD-AGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF1","description":"ICD-OBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC1","description":"ICD-JDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29866","description":"Autgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF0","description":"ICD-CAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate pharynx/uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42145","description":"Repair palate pharynx/uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB1","description":"ICD-JAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA51","description":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE0","description":"ICD-CCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE0","description":"ICD-FAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1023","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB0","description":"ICD-KEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD1","description":"ICD-OCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of leg infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73592","description":"X-ray exam of leg infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269T","description":"Rev/remvl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD1","description":"ICD-GBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB1","description":"ICD-PEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB20","description":"Low Rehab_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99454","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54326","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA1","description":"ICD-CBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43283","description":"Lap esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3299","description":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38700","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL41","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA0","description":"ICD-PDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD1","description":"ICD-DIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE1","description":"ICD-OIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lice treatment_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9180","description":"Lice treatment_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF1","description":"ICD-GCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph egd dilation <30 mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43249","description":"Esoph egd dilation <30 mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1805","description":"CDT-D1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD0","description":"ICD-GCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA0","description":"ICD-GCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28062","description":"Removal of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92230","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of metatarsal heads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28114","description":"Removal of metatarsal heads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD1","description":"ICD-NDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65272","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67515","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2170","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33777","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inter limb compress dev nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0676","description":"Inter limb compress dev nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD0","description":"ICD-KGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27244","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1016T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","description":"CPT-1016T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE246","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Promethazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2550","description":"Promethazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carecoordination prenatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1002","description":"Carecoordination prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heinz bodies direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85441","description":"Heinz bodies direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61330","description":"Decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0510T","description":"Removal of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD1","description":"ICD-OGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD1","description":"ICD-OARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No implantable/insertable device used with device-intensive procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1890","description":"No implantable/insertable device used with device-intensive procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA1","description":"ICD-OJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43832","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE1","description":"ICD-FBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB0","description":"ICD-GCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE0","description":"ICD-MBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD0","description":"ICD-MKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adolesc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90743","description":"Hepb vacc 2 dose adolesc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA0","description":"ICD-FDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21247","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33786","description":"Repair arterial trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA0","description":"ICD-JEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8717","description":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC21","description":"ICD-3IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC155","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD1","description":"ICD-JEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD0","description":"ICD-HFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment bodysuit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6501","description":"Compres burngarment bodysuit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE1","description":"ICD-OBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock multi ply upper lm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8435","description":"Pros sock multi ply upper lm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD0","description":"ICD-IDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC1","description":"ICD-HFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE1","description":"ICD-OBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0245","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glucosidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82963","description":"Assay of glucosidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC0","description":"ICD-KEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjustable chair for esrd pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1570","description":"Adjustable chair for esrd pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE1","description":"ICD-GDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC0","description":"ICD-OCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF1","description":"ICD-CAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE246","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE0","description":"ICD-NACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC1","description":"ICD-GIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9492","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC0","description":"ICD-NFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE0","description":"ICD-GDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC0","description":"ICD-FCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC0","description":"ICD-NIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB0","description":"ICD-DARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF0","description":"ICD-NGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC0","description":"ICD-BIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF0","description":"ICD-JBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SanoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4319","description":"SanoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB204","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB0","description":"ICD-OKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB113","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD0","description":"ICD-GCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC0","description":"ICD-CAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Max MRI capture & interprete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0369","description":"Max MRI capture & interprete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mold socket ank hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5010","description":"Mold socket ank hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD141","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF1","description":"ICD-EEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE256","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70491","description":"Ct soft tissue neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0884","description":"Pwc gp4 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD0","description":"ICD-DFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0787","description":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE0","description":"ICD-EIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB1","description":"ICD-KHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","description":"HCPCS-J9028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evasc rpr iliac art bifr s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255T","description":"Evasc rpr iliac art bifr s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75978","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC1","description":"ICD-DGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB1","description":"ICD-CEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA21","description":"ICD-2BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB42","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC1","description":"ICD-OFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE0","description":"ICD-LHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF1","description":"ICD-ODWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA0","description":"ICD-CFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pt care icu/vent in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4169F","description":"No pt care icu/vent in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB0","description":"ICD-JCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB0","description":"ICD-ICCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC0","description":"ICD-KBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9975","description":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB1","description":"ICD-NLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD224","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE1","description":"ICD-MDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7213","description":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90756","description":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB0","description":"ICD-KARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF0","description":"ICD-EEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33278","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC1","description":"ICD-JCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bordetella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86615","description":"Bordetella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD1","description":"ICD-NLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35013","description":"Repair artery rupture arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE0","description":"ICD-EICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1713","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC1","description":"ICD-PBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supp for self-adm injections","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4211","description":"Supp for self-adm injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB1","description":"ICD-FHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6010","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31375","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA0","description":"ICD-CBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap f/c/c/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15620","description":"Delay flap f/c/c/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72010","description":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA1","description":"ICD-KEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy cerv/thor facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64633","description":"Destroy cerv/thor facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA0","description":"ICD-CETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLD0","description":"ICD-KBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC1","description":"ICD-NIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood prep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86930","description":"Frozen blood prep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF0","description":"ICD-ECDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temp obturator prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5936","description":"Temp obturator prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC1","description":"ICD-GEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87184","description":"Microbe susceptible disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF1","description":"ICD-MGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD0","description":"ICD-GHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD0","description":"ICD-GFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC0","description":"ICD-HBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB1","description":"ICD-OKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC1","description":"ICD-BIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9457","description":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4355","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","description":"HCPCS-Q4355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC14","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Receiver/transmitter_ neuro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1816","description":"Receiver/transmitter_ neuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Musc tst done w/nerv tst lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95885","description":"Musc tst done w/nerv tst lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB0","description":"ICD-NBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB0","description":"ICD-MCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27428","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion (mpr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59866","description":"Abortion (mpr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA0","description":"ICD-MATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE1","description":"ICD-KITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enfuvirtide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1324","description":"Enfuvirtide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deoxyribonuclease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86215","description":"Deoxyribonuclease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Door to punc time >2hr_ nrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9582","description":"Door to punc time >2hr_ nrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vertical shock reducing pylo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5988","description":"Vertical shock reducing pylo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No statin/no order statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9665","description":"No statin/no order statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat pleurodesis w/agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32560","description":"Treat pleurodesis w/agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC0","description":"ICD-DFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF0","description":"ICD-CAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","description":"HCPCS-M1469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE1","description":"ICD-OCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF0","description":"ICD-FGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA0","description":"ICD-ADHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28086","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND1","description":"ICD-GCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneum full leg splnt pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4370","description":"Pneum full leg splnt pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0737","description":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF0","description":"ICD-MJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE0","description":"ICD-OCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0512","description":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC1","description":"ICD-NHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA101","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA0","description":"ICD-IFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5063","description":"Drain ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA1","description":"ICD-ODMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE1","description":"ICD-ODJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE1","description":"ICD-OJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB0","description":"ICD-JCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA0","description":"ICD-LDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC05","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54322","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99384","description":"Prev visit new age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78835","description":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC0","description":"ICD-ODFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trac stand free stand extrem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0880","description":"Trac stand free stand extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC1","description":"ICD-NAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE1","description":"ICD-ABCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB0","description":"ICD-OBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC0","description":"ICD-NIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB0","description":"ICD-AAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3652","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE0","description":"ICD-OEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External receiver_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9278","description":"External receiver_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE0","description":"ICD-FBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF1","description":"ICD-BBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vkorc1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81355","description":"Vkorc1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99150","description":"Mod sed diff phys/qhp add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA0","description":"ICD-CEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit postnatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99501","description":"Home visit postnatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01650","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","description":"CPT-01650","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD1","description":"ICD-OGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB1","description":"ICD-CBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD1","description":"ICD-NHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE0","description":"ICD-MJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ home monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9006","description":"Mccd_ home monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC1","description":"ICD-ODKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC1","description":"ICD-GDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1348","description":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE1","description":"ICD-FEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB1","description":"ICD-NEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","description":"HCPCS-G0552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 200-249mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9960","description":"Hocm 200-249mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB224","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA1","description":"ICD-BIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD0","description":"ICD-KHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA0","description":"ICD-OLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD0","description":"ICD-CGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sialidase enzyme assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87905","description":"Sialidase enzyme assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33237","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9949","description":"Repair of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD1","description":"ICD-GDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC0","description":"ICD-JGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB0","description":"ICD-GGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF1","description":"ICD-GGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE1","description":"ICD-BILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1489","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","description":"HCPCS-M1489","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE0","description":"ICD-NIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB106","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 4 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34844","description":"Endovasc visc aorta 4 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD0","description":"ICD-BDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF1","description":"ICD-CHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5241","description":"Dispensing fee_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA0","description":"ICD-NDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC0","description":"ICD-EBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5259","description":"Hearing aid_ digit_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis auto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81001","description":"Urinalysis auto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3C","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27562","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC0","description":"ICD-BGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF1","description":"ICD-OGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC0","description":"ICD-ECEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF0","description":"ICD-KBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contracept iud","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4989","description":"Contracept iud","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"F5 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81241","description":"F5 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit int pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9327","description":"Hit int pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA0","description":"ICD-KFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20979","description":"Us bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF0","description":"ICD-GARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA1","description":"ICD-FGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ peramivir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2547","description":"Injection_ peramivir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF0","description":"ICD-KDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF0","description":"ICD-NLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD0","description":"ICD-EFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA236","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD1","description":"ICD-KDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49654","description":"Lap inc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Octagam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1568","description":"Octagam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear diagnostic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78999","description":"Nuclear diagnostic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC0","description":"ICD-IIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF1","description":"ICD-OKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31238","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have had a hysterectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9774","description":"Patients who have had a hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vacc no prsv 6-35 m im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90685","description":"Iiv4 vacc no prsv 6-35 m im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26561","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE1","description":"ICD-EGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minor blunt trauma w/head ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9529","description":"Minor blunt trauma w/head ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND0","description":"ICD-CCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smoking & 2nd hand assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1031F","description":"Smoking & 2nd hand assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA1","description":"ICD-LHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive testis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54535","description":"Extensive testis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF0","description":"ICD-ODFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF1","description":"ICD-OHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54550","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC1","description":"ICD-FCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF0","description":"ICD-OGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB0","description":"ICD-OBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF0","description":"ICD-BBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67112","description":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80506","description":"Pathology Clinical Consultation; Prolonged Service_ Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME0","description":"ICD-ACME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean birth class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9438","description":"Cesarean birth class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36558","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD1","description":"ICD-CFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2146","description":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC1","description":"ICD-KCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA40","description":"High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB1","description":"ICD-BAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1749","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","description":"HCPCS-J1749","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients on peritoneal dialysis for any portion of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0052","description":"Patients on peritoneal dialysis for any portion of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF1","description":"ICD-DDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB1","description":"ICD-CHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC1","description":"ICD-BHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"removal of non-resorbable barrier","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4286","description":"removal of non-resorbable barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rotator cuff chronic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23412","description":"Repair rotator cuff chronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD0","description":"ICD-KFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0513","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE0","description":"ICD-NCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair standard w/ leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1150","description":"Wheelchair standard w/ leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE0","description":"ICD-IHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE1","description":"ICD-JBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22852","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB0","description":"ICD-NJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB244","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein bld by nmr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83704","description":"Lipoprotein bld by nmr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stem cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86367","description":"Stem cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB254","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA1","description":"ICD-CDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4368","description":"Ostomy filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17284","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF0","description":"ICD-BCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62659","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB0","description":"ICD-GDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA0","description":"ICD-PAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA36","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0623U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","description":"CPT-0623U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Px sup fee anti-can sub pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0512","description":"Px sup fee anti-can sub pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA0","description":"ICD-JBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID1","description":"ICD-MIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zanamivir_ inh pwdr_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9034","description":"Zanamivir_ inh pwdr_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA0","description":"ICD-FBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES124","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE1","description":"ICD-OIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-durometer below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5665","description":"Multi-durometer below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5639","description":"Below knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC0","description":"ICD-BBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB1","description":"ICD-BDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0782T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bp scrn no perf at interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8785","description":"Bp scrn no perf at interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27372","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB1","description":"ICD-CHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD225","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE1","description":"ICD-NJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37615","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC1","description":"ICD-LASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF0","description":"ICD-BGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80343","description":"Antipsychotics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD1","description":"ICD-OCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA0","description":"ICD-EHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28760","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF0","description":"ICD-GHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abdominal arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75635","description":"Ct angio abdominal arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81181","description":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemagglutination inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86280","description":"Hemagglutination inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anes mediascpy & dx thorscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52851","description":"Anes mediascpy & dx thorscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME0","description":"ICD-NHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB1","description":"ICD-BGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE260","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC1","description":"ICD-FEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0649U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0649U","description":"CPT-0649U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF1","description":"ICD-PKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB0","description":"ICD-CDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE1","description":"ICD-FBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD1","description":"ICD-KCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB0","description":"ICD-MCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","description":"HCPCS-J1098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB60","description":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA0","description":"ICD-MELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace prox & dist upright","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4070","description":"Replace prox & dist upright","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF0","description":"ICD-GDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68326","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00144","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","description":"CPT-00144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB1","description":"ICD-CFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC1","description":"ICD-FGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB0","description":"ICD-KEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB130","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for 6 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1134F","description":"Epsd bk pain for 6 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","description":"HCPCS-A9615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of 17-hydroxypregneno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84143","description":"Assay of 17-hydroxypregneno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","description":"HCPCS-M1440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB1","description":"ICD-FEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1047","description":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB1","description":"ICD-BIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL60","description":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB0","description":"ICD-EGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB1","description":"ICD-CEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1453","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","description":"HCPCS-M1453","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB1","description":"ICD-EGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD1","description":"ICD-KCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB1","description":"ICD-MHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin fat pad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15838","description":"Excise excess skin fat pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC0","description":"ICD-BCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA0","description":"ICD-CGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zenith Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4253","description":"Zenith Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF1","description":"ICD-KBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE0","description":"ICD-MDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cover ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5705","description":"Custom shape cover ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0752","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","description":"HCPCS-J0752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no tx sys bio rx 6 mths","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9653","description":"Pt no tx sys bio rx 6 mths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening tramadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80373","description":"Drug screening tramadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluorouracil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9190","description":"Fluorouracil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57260","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF1","description":"ICD-EGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB130","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29870","description":"Knee arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD1","description":"ICD-HDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE151","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer system <300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1035","description":"Patient transfer system <300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Feces culture aerobic bact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87045","description":"Feces culture aerobic bact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB0","description":"ICD-BHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8670","description":"Rolapitant_ oral_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE0","description":"ICD-OKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24675","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvng antivir txmnt hepc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4150F","description":"Pt recvng antivir txmnt hepc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA0","description":"ICD-NGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB1","description":"ICD-ICTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA1","description":"ICD-CAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB1","description":"ICD-IBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap revise gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43771","description":"Lap revise gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81414","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1029T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1029T","description":"CPT-1029T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth tubal ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85151","description":"Anesth tubal ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0802","description":"HCPCS-B0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72158","description":"MRI lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE1","description":"ICD-NGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus probe&revrs trns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87498","description":"Enterovirus probe&revrs trns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2109","description":"Spherocylinder 4.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID1","description":"ICD-NJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF0","description":"ICD-BEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise hernia & sperm veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55540","description":"Revise hernia & sperm veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2311","description":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76988","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF0","description":"ICD-METF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36160","description":"Establish access to aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE0","description":"ICD-BAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA11","description":"ICD-2AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF1","description":"ICD-HDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID0","description":"ICD-ADID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB1","description":"ICD-PERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2A","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5C","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1228","description":"Wheelchair spec sz spec ht b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01951","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","description":"CPT-01951","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE1","description":"ICD-JDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5751","description":"Denture reln cmplt mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7202","description":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1203","description":"HCPCS-A1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12031","description":"Intmd rpr s/a/t/ext 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF1","description":"ICD-ABAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/signal-averaged","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93278","description":"Ecg/signal-averaged","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF1","description":"ICD-OIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD1","description":"ICD-NLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost a/e ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7401","description":"Add ue prost a/e ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB1","description":"ICD-EGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of breast open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19101","description":"Biopsy of breast open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD1","description":"ICD-GBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90621","description":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF0","description":"ICD-MFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD0","description":"ICD-BCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF0","description":"ICD-KIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mrcp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8037","description":"Mrcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recement supp crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6092","description":"Recement supp crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF0","description":"ICD-BBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD1","description":"ICD-OFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC1","description":"ICD-CBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast cancer dx min invsive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8875","description":"Breast cancer dx min invsive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27455","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB0","description":"ICD-OFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF0","description":"ICD-NBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB1","description":"ICD-CDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB21","description":"ICD-1CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA1","description":"ICD-CESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation thru metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28805","description":"Amputation thru metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy titrate-airborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95027","description":"Icut allergy titrate-airborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB1","description":"ICD-PDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF1","description":"ICD-ABIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF0","description":"ICD-OHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No impro med time pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9427","description":"No impro med time pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49610","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB0","description":"ICD-FCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0666T","description":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB0","description":"ICD-OGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE1","description":"ICD-BCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD0","description":"ICD-NDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE0","description":"ICD-MGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB0","description":"ICD-ODRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA0","description":"ICD-NFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB31","description":"ICD-1GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF0","description":"ICD-NKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC0","description":"ICD-CIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10080","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC0","description":"ICD-OFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory test limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92587","description":"Evoked auditory test limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC1","description":"ICD-NKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA0","description":"ICD-GDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sialodochoplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7982","description":"Sialodochoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA45","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gr24 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2363","description":"Gr24 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8E","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB1","description":"ICD-KBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40844","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47720","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF0","description":"ICD-BBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27253","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB1","description":"ICD-FEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 2nd dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0250","description":"Adm Tocilizu COVID-19 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9362","description":"Implnt_bon void filler-strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27625","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0050U","description":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv vacc pandemic adjuvt im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90667","description":"Iiv vacc pandemic adjuvt im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC1","description":"ICD-NIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD0","description":"ICD-NITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE1","description":"ICD-JBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA1","description":"ICD-LGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99500","description":"Home visit prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA0","description":"ICD-JCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91299","description":"Gastroenterology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA1","description":"ICD-GHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA0","description":"ICD-EEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD0","description":"ICD-FCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA1","description":"ICD-ADDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27197","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD0","description":"ICD-JFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tb scrng done-interpd 6mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3455F","description":"Tb scrng done-interpd 6mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF1","description":"ICD-JGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE0","description":"ICD-LBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517F","description":"Glaucoma plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF0","description":"ICD-CEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE1","description":"ICD-JHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19316","description":"Suspension of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE0","description":"ICD-MELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD1","description":"ICD-JCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA0","description":"ICD-ICBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31235","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC0","description":"ICD-IFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF0","description":"ICD-OGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA0","description":"ICD-HHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF1","description":"ICD-GGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31276","description":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD1","description":"ICD-MFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33746","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4025","description":"Cast sup hip spica plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB43","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA1","description":"ICD-KIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer tub rail attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0246","description":"Transfer tub rail attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0654U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0654U","description":"CPT-0654U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD0","description":"ICD-EAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0848","description":"Pwc gp 3 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy abdom complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58146","description":"Myomectomy abdom complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA1","description":"ICD-FELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93150","description":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA144","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA11","description":"ICD-4AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC0","description":"ICD-GGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC1","description":"ICD-NHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhs/hospice of lpn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0300","description":"Hhs/hospice of lpn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC1","description":"ICD-NENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HER2-targeted therapies not administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9827","description":"HER2-targeted therapies not administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lecanemab-irmb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0174","description":"Injection_ lecanemab-irmb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0507","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD1","description":"ICD-NKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB221","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB1","description":"ICD-EALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA0","description":"ICD-GAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5916","description":"Ocular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF1","description":"ICD-CAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB0","description":"ICD-CCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC1","description":"ICD-OBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF1","description":"ICD-FBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE1","description":"ICD-KECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45346","description":"Sigmoidoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD1","description":"ICD-GCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB1","description":"ICD-MGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD1","description":"ICD-MAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0569T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE1","description":"ICD-BHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB0","description":"ICD-KEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exoskel hip ultra-light mate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5795","description":"Exoskel hip ultra-light mate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB1","description":"ICD-GBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB251","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE1","description":"ICD-CHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF1","description":"ICD-OHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29055","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (Evomela)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9246","description":"Injection_ melphalan (Evomela)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF1","description":"ICD-CGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp ext fixate strut change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20697","description":"Comp ext fixate strut change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21555","description":"Exc neck les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB1","description":"ICD-IIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF0","description":"ICD-FBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nail plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11730","description":"Removal of nail plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5944","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5944","description":"CDT-D5944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pcp proph low cd4 norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9217","description":"No pcp proph low cd4 norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25680","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC0","description":"ICD-IATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1106","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF0","description":"ICD-GDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE0","description":"ICD-OCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/o stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4082","description":"Enteral ng tubing w/o stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF1","description":"ICD-PGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0649","description":"Lso sc r pos/lat pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC0","description":"ICD-OFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF0","description":"ICD-FCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4048F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE0","description":"ICD-MGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB1","description":"ICD-OARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA0","description":"ICD-JFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE0","description":"ICD-HDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE0","description":"ICD-KISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA212","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA0","description":"ICD-KFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE0","description":"ICD-KGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF0","description":"ICD-HDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB1","description":"ICD-LFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF1","description":"ICD-GHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE0","description":"ICD-BEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA0","description":"ICD-NIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of lingual tonsil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42870","description":"Excision of lingual tonsil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Large size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0041","description":"Large size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD1","description":"ICD-GCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD1","description":"ICD-IIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC1","description":"ICD-KHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC0","description":"ICD-HHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE1","description":"ICD-BDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF1","description":"ICD-KFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC0","description":"ICD-FEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA1","description":"ICD-FBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA1","description":"ICD-FICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF0","description":"ICD-OGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC1","description":"ICD-OAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1748","description":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD0","description":"ICD-LISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52281","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF1","description":"ICD-GACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX53","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC1","description":"ICD-GEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA1","description":"ICD-OKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76377","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0902","description":"HCPCS-A0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED1","description":"ICD-AEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply spine prosth device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22851","description":"Apply spine prosth device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9752","description":"Emergency surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"History of preoperative posterior capsule rupture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9759","description":"History of preoperative posterior capsule rupture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE1","description":"ICD-ACIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous tibial nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0736","description":"Transcutaneous tibial nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8697","description":"Repair Of Orthodontic Appliance - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9268","description":"Doc comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE1","description":"ICD-OBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE0","description":"ICD-OCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED0","description":"ICD-AAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB1","description":"ICD-FBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD1","description":"ICD-NCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1012","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE0","description":"ICD-CDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF1","description":"ICD-PIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC0","description":"ICD-MBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1362","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC0","description":"ICD-CGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF0","description":"ICD-KIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84120","description":"Assay of urine porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Bezlotoxumab 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9490","description":"Injection Bezlotoxumab 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt cat and thck on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9294","description":"Pt cat and thck on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breathing circuits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4618","description":"Breathing circuits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29821","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86023","description":"Immunoglobulin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD1","description":"ICD-AHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22633","description":"Lumbar spine fusion combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA1","description":"ICD-JDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC1","description":"ICD-KFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB1","description":"ICD-EFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC0","description":"ICD-CARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB1","description":"ICD-CISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46600","description":"Diagnostic anoscopy spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provision splnt intracoronal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4320","description":"Provision splnt intracoronal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB0","description":"ICD-NGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ccp antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86200","description":"Ccp antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA0","description":"ICD-OCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01966","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","description":"CPT-01966","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special base curve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2730","description":"Special base curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8994","description":"Sub pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF1","description":"ICD-JDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC241","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99411","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF0","description":"ICD-AIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA0","description":"ICD-MHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9781","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308U","description":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF0","description":"ICD-BGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD1","description":"ICD-BGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF1","description":"ICD-NICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA32","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0689T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1138","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB1","description":"ICD-CARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF0","description":"ICD-NHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB1","description":"ICD-HDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC0","description":"ICD-KDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prostate saturation sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55706","description":"Prostate saturation sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1902","description":"HCPCS-C1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF1","description":"ICD-EHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB42","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special anesthesia procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99135","description":"Special anesthesia procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA1","description":"ICD-OLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tubing with heating element","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4604","description":"Tubing with heating element","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF1","description":"ICD-OANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF0","description":"ICD-AHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent prenatal care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502F","description":"Subsequent prenatal care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D8671","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8671","description":"CDT-D8671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF0","description":"ICD-BDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF0","description":"ICD-BEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF0","description":"ICD-CHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD0","description":"ICD-OCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 75 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1850","description":"Kanamycin sulfate 75 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF0","description":"ICD-OBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","description":"HCPCS-M1407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424U","description":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE1","description":"ICD-OLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1720","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1720","description":"CDT-D1720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 3/> node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31653","description":"Bronch ebus samplng 3/> node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27477","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC1","description":"ICD-LGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC1","description":"ICD-OKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27331","description":"Explore/treat knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC0","description":"ICD-BABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290U","description":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked upr&lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95939","description":"C motor evoked upr&lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE0","description":"ICD-JCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB1","description":"ICD-GEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB0","description":"ICD-GCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF0","description":"ICD-HHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF0","description":"ICD-OLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64570","description":"Remove vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr rem hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49550","description":"Rpr rem hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29879","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF0","description":"ICD-JGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC1","description":"ICD-BDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elosulfase alfa_ injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1322","description":"Elosulfase alfa_ injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9998","description":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE0","description":"ICD-IDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost be/wd_ ultlite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7400","description":"Add ue prost be/wd_ ultlite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA1","description":"ICD-KAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD1","description":"ICD-JGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46910","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tube_ pneum wheel drive tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2382","description":"Tube_ pneum wheel drive tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD0","description":"ICD-BHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD0","description":"ICD-KGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC31","description":"ICD-1AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB1","description":"ICD-GDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF0","description":"ICD-FIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0882","description":"Darbepoetin alfa_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB0","description":"ICD-IEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16075","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16075","description":"CPT-16075","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB1","description":"ICD-CENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE1","description":"ICD-FFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE0","description":"ICD-KERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA0","description":"ICD-JEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cell enumeration phys interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86153","description":"Cell enumeration phys interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF1","description":"ICD-CFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral function therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92526","description":"Oral function therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal maint procedures","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4910","description":"Periodontal maint procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA206","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA11","description":"ICD-4JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA1","description":"ICD-LAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA0","description":"ICD-PEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bowel lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44111","description":"Excision of bowel lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF0","description":"ICD-FEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC1","description":"ICD-KBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4594","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26483","description":"Transplant/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB256","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD1","description":"ICD-DIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB1","description":"ICD-GHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of bone cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20615","description":"Treatment of bone cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC145","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE0","description":"ICD-AIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC256","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retrograde filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3430","description":"Retrograde filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5964","description":"Above knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37237","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB0","description":"ICD-CFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC1","description":"ICD-NBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21255","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD1","description":"ICD-OKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA1","description":"ICD-AFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC1","description":"ICD-HCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB1","description":"ICD-MHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469T","description":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC1","description":"ICD-IFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00921","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","description":"CPT-00921","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF1","description":"ICD-OGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF0","description":"ICD-BCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is currently on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9796","description":"Patient is currently on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC1","description":"ICD-BAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF1","description":"ICD-AEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC0","description":"ICD-KCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81336","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE0","description":"ICD-BHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE1","description":"ICD-FCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA0","description":"ICD-CDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Redo endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37192","description":"Redo endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC1","description":"ICD-NBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC230","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF0","description":"ICD-MHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo w/shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1007","description":"Pwr seat combo w/shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd esophagogastrc fndoplsty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43210","description":"Egd esophagogastrc fndoplsty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE1","description":"ICD-BBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excellagen_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4149","description":"Excellagen_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC0","description":"ICD-MAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB0","description":"ICD-OHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX22","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE0","description":"ICD-IGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81222","description":"Cftr gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA0","description":"ICD-CADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress disc rf lumbar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2348","description":"Decompress disc rf lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML52","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1015","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED0","description":"ICD-IGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC0","description":"ICD-JAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove for body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46608","description":"Anoscopy remove for body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Etidronate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1436","description":"Etidronate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB1","description":"ICD-GDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB101","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB1","description":"ICD-HFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB154","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD1","description":"ICD-FCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB1","description":"ICD-LDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF1","description":"ICD-GAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1712","description":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Satisfy survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0917","description":"Satisfy survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC1","description":"ICD-EALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx crisis initial 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90839","description":"Psytx crisis initial 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50693","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1103T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1103T","description":"CPT-1103T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021A","description":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0485","description":"Oral device/appliance prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC0","description":"ICD-IEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED0","description":"ICD-CFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cur meds not document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8428","description":"Cur meds not document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC1","description":"ICD-FATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD0","description":"ICD-OAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA0","description":"ICD-BEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA52","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Als routine disposble suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0398","description":"Als routine disposble suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD112","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38572","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11005","description":"Debride abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD0","description":"ICD-KDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33866","description":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD0","description":"ICD-AIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Tocilizumab for COVID-19 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0249","description":"Injection Tocilizumab for COVID-19 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg 41-60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95812","description":"Eeg 41-60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA1","description":"ICD-JGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venous thrombosis imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78457","description":"Venous thrombosis imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE0","description":"ICD-LCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD1","description":"ICD-CIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF0","description":"ICD-NAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA1","description":"ICD-OBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC0","description":"ICD-KFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA0","description":"ICD-BIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE0","description":"ICD-ODUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD0","description":"ICD-OGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD0","description":"ICD-NKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA0","description":"ICD-FGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33851","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254U","description":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE1","description":"ICD-IAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB0","description":"ICD-BAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair modified fontan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33615","description":"Repair modified fontan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA0","description":"ICD-JAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36907","description":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc dx unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9067","description":"Onc dx nsclc dx unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA0","description":"ICD-ECMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8C","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF0","description":"ICD-NFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD0","description":"ICD-OGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC1","description":"ICD-NLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1709","description":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9250","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5996","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE0","description":"ICD-NIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD1","description":"ICD-OJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB1","description":"ICD-CGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD205","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA0","description":"ICD-OBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotx admn prtl cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96446","description":"Chemotx admn prtl cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD1","description":"ICD-ODTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF0","description":"ICD-CEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75726","description":"Artery x-rays abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX14","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1733","description":"Employment - Job Coaching 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unspec maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8048","description":"Unspec maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE1","description":"ICD-DARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB0","description":"ICD-BCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7332","description":"Hyaluronan or derivative_ triluron_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE1","description":"ICD-PKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF1","description":"ICD-KIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE1","description":"ICD-NDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3929","description":"Hfo nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE126","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB1","description":"ICD-GAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue mouth jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41150","description":"Tongue mouth jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","description":"CPT-15011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE1","description":"ICD-FGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB0","description":"ICD-BEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA0","description":"ICD-OJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA1","description":"ICD-KGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA0","description":"ICD-FEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26437","description":"Realignment of tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62192","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61533","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66680","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0862","description":"Pwc gp3 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC1","description":"ICD-BFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC0","description":"ICD-CEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA0","description":"ICD-JDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE1","description":"ICD-FAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1097","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA1","description":"ICD-FATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX15","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB0","description":"ICD-FGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB1","description":"ICD-IHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE0","description":"ICD-OHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD0","description":"ICD-MELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA0","description":"ICD-GIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA1","description":"ICD-CECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice/home hlth_ place nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5009","description":"Hospice/home hlth_ place nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA0","description":"ICD-CBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE0","description":"ICD-JDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb b-blockertx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4480F","description":"Pt rcvng ace/arb b-blockertx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD1","description":"ICD-NETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap replace gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43773","description":"Lap replace gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB0","description":"ICD-FEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27557","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD0","description":"ICD-BHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7902","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE0","description":"ICD-ECHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD0","description":"ICD-FIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB54","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1338","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES311","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA1","description":"ICD-BEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009U","description":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plt_ pher_ l/r cmv-neg_ irr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9053","description":"Plt_ pher_ l/r cmv-neg_ irr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA1","description":"ICD-HDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF0","description":"ICD-FAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","description":"HCPCS-Q4407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86870","description":"Rbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ue triple control harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6677","description":"Ue triple control harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psych svcs provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4060F","description":"Psych svcs provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD1","description":"ICD-MCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49659","description":"Laparo proc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded ankle gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1904","description":"Afo molded ankle gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID0","description":"ICD-KBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98971","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74445","description":"X-ray exam of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6067","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB1","description":"ICD-EGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid lined pre one pie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0488","description":"Tlso rigid lined pre one pie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF1","description":"ICD-ABHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC0","description":"ICD-EBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc rsn do qual life assm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9635","description":"No doc rsn do qual life assm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE1","description":"ICD-OKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE1","description":"ICD-LARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant trans coil repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8617","description":"Coch implant trans coil repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB1","description":"ICD-JGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD0","description":"ICD-BADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB0","description":"ICD-BDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2145","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE0","description":"ICD-EDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranial cervical torticollis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0113","description":"Cranial cervical torticollis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD1","description":"ICD-LFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1109T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1109T","description":"CPT-1109T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB1","description":"ICD-BGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE1","description":"ICD-NAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC0","description":"ICD-CBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB0","description":"ICD-PHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD0","description":"ICD-OKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA1","description":"ICD-IBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF1","description":"ICD-CIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD0","description":"ICD-GEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33871","description":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69530","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC1","description":"ICD-JCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pjp proph ordered low cd4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9222","description":"Pjp proph ordered low cd4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9364","description":"Hit tpn total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0516","description":"Safety frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB0","description":"ICD-EGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB250","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27256","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4367","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","description":"HCPCS-Q4367","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81298","description":"Msh6 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Counterimmunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86185","description":"Counterimmunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"G compression stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6549","description":"G compression stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF0","description":"ICD-IGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB1","description":"ICD-JGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8913","description":"Mra w/o cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA1","description":"ICD-GCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9883","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8008","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8008","description":"HCPCS-C8008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE0","description":"ICD-NAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA0","description":"ICD-KHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE1","description":"ICD-JHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB0","description":"ICD-NICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE1","description":"ICD-IADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC1","description":"ICD-BIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC1","description":"ICD-CBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digital sub 2 or more images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0394","description":"Digital sub 2 or more images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cancer treatmentplan initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0353","description":"Cancer treatmentplan initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay carboxyhb quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82375","description":"Assay carboxyhb quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD1","description":"ICD-CDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF1","description":"ICD-NIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF0","description":"ICD-LHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF0","description":"ICD-HHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44320","description":"Colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB1","description":"ICD-PGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-pop-tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35623","description":"Art byp axillary-pop-tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0884T","description":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471U","description":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0877","description":"Pwc gp4 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99254","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD0","description":"ICD-CIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55821","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE1","description":"ICD-GEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA0","description":"ICD-EGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC1","description":"ICD-KIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54135","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sach foot_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5971","description":"Sach foot_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cane adjust/fixed with tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0100","description":"Cane adjust/fixed with tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nitroblue tetrazolium dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86384","description":"Nitroblue tetrazolium dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth facility fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3014","description":"Telehealth facility fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD1","description":"ICD-IDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF0","description":"ICD-JIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD1","description":"ICD-NIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0573U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","description":"CPT-0573U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of ureter tube/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50688","description":"Change of ureter tube/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32215","description":"Treat chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70552","description":"MRI brain stem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj pudendal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64430","description":"N block inj pudendal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA1","description":"ICD-JHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0196","description":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2068","description":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD0","description":"ICD-DHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33315","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB1","description":"ICD-EDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urokinase 5000 iu injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3364","description":"Urokinase 5000 iu injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21422","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC0","description":"ICD-PHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23921","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC0","description":"ICD-OLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47120","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD1","description":"ICD-CHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0491","description":"Tlso 2 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF0","description":"ICD-GGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB0","description":"ICD-BIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mucormycosis antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86732","description":"Mucormycosis antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC1","description":"ICD-JDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Golimumab for iv use 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1602","description":"Golimumab for iv use 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","description":"CPT-15013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE1","description":"ICD-NBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB0","description":"ICD-CGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF0","description":"ICD-CEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12004","description":"Rpr s/n/ax/gen/trk7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB1","description":"ICD-OFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD1","description":"ICD-ADCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF1","description":"ICD-KDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1368","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Musculoskeletal nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78399","description":"Musculoskeletal nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC0","description":"ICD-GFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB1","description":"ICD-IDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asparaginase_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9020","description":"Asparaginase_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ropivacaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2795","description":"Ropivacaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB0","description":"ICD-NEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal with training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2025","description":"Telecare equipment installation and removal with training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX55","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wilate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7183","description":"Wilate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15877","description":"Suction lipectomy trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0827","description":"Pwc gp vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC1","description":"ICD-BDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB0","description":"ICD-BAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31225","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA1","description":"ICD-GIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC1","description":"ICD-KGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA0","description":"ICD-KHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND0","description":"ICD-ODND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA1","description":"ICD-BEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC0","description":"ICD-GEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB0","description":"ICD-OJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle transfer shoulder/arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23395","description":"Muscle transfer shoulder/arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB0","description":"ICD-JBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA0","description":"ICD-GEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF1","description":"ICD-CEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB30","description":"Medium Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system liquid station","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0440","description":"Oxygen system liquid station","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA0","description":"ICD-DCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB1","description":"ICD-OFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE0","description":"ICD-BDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD0","description":"ICD-EECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB0","description":"ICD-FFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB1","description":"ICD-ODMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly or PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4172","description":"PuraPly or PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA1","description":"ICD-BIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE0","description":"ICD-KIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0007","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phleb veins - extrem 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37766","description":"Phleb veins - extrem 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD1","description":"ICD-MEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD1","description":"ICD-BBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","description":"HCPCS-M1372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases o2 sat only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82810","description":"Blood gases o2 sat only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80350","description":"Cannabinoids synthetic 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC1","description":"ICD-JIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cryoglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82595","description":"Assay of cryoglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA0","description":"ICD-NKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81463","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD0","description":"ICD-IBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA0","description":"ICD-OEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB0","description":"ICD-IBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0688U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688U","description":"CPT-0688U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE0","description":"ICD-GFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC0","description":"ICD-OFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB1","description":"ICD-HGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB1","description":"ICD-KDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic antiplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85410","description":"Fibrinolytic antiplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59325","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA0","description":"ICD-NJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC1","description":"ICD-HHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC1","description":"ICD-GARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to palliative care services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1017","description":"Patient admitted to palliative care services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC1","description":"ICD-MABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22210","description":"Incis 1 vertebral seg cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE1","description":"ICD-KBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0495T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC206","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID0","description":"ICD-IIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-84394","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","description":"CPT-84394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD156","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF0","description":"ICD-HGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1A","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337U","description":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA0","description":"ICD-IBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD1","description":"ICD-GBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF0","description":"ICD-JDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF1","description":"ICD-IGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA1","description":"ICD-FDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9507","description":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame dual w cross","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0946","description":"Fracture frame dual w cross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB0","description":"ICD-JEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44369","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33470","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA0","description":"ICD-OAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levetiracetam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1953","description":"Levetiracetam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8000","description":"Soft protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glasses bone conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5080","description":"Glasses bone conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE1","description":"ICD-CCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corplex_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4232","description":"Corplex_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15958","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct midface w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7949","description":"Reconstruct midface w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin b-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82607","description":"Vitamin b-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66505","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF0","description":"ICD-PLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77049","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0676T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92531","description":"Spontaneous nystagmus study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","description":"CPT-00210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA0","description":"ICD-OIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF1","description":"ICD-FEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE0","description":"ICD-OKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF1","description":"ICD-AILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD1","description":"ICD-JIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64784","description":"Remove nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81339","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE1","description":"ICD-JHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD0","description":"ICD-KEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE0","description":"ICD-OIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB1","description":"ICD-NENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55600","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26037","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE0","description":"ICD-JEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6980","description":"Bridge repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB0","description":"ICD-BFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC1","description":"ICD-ABMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC1","description":"ICD-LCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA1","description":"ICD-GFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68325","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78804","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF0","description":"ICD-MAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm a-grft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15116","description":"Epidrm a-grft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC0","description":"ICD-OEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF0","description":"ICD-NJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Participant-Directed Goods and Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1901","description":"Participant-Directed Goods and Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hast w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94452","description":"Hast w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF1","description":"ICD-KCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC1","description":"ICD-NFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Giardia lamblia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86674","description":"Giardia lamblia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF0","description":"ICD-MJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 35","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0408","description":"Inpt/tele follow up 35","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Halo repl liner/interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0861","description":"Halo repl liner/interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD1","description":"ICD-FGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF0","description":"ICD-EGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB0","description":"ICD-OENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spoke protectors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0065","description":"Spoke protectors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF1","description":"ICD-MBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC1","description":"ICD-DGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC0","description":"ICD-KBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD0","description":"ICD-LBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC0","description":"ICD-GHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED0","description":"ICD-JBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC0","description":"ICD-KBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plicamycin (mithramycin) inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9270","description":"Plicamycin (mithramycin) inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lingual frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7962","description":"Lingual frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395U","description":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD1","description":"ICD-IETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF0","description":"ICD-MBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monoclonal antibodies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7505","description":"Monoclonal antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB1","description":"ICD-MBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iron binding test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83550","description":"Iron binding test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD1","description":"ICD-PFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncoprotein her-2/neu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83950","description":"Oncoprotein her-2/neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF1","description":"ICD-EHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnioband_ guardian 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4151","description":"Amnioband_ guardian 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carmustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9050","description":"Carmustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28299","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj dexamethasone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1094","description":"Inj dexamethasone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB0","description":"ICD-BDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27266","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML20","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2253","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","description":"HCPCS-J2253","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX05","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD0","description":"ICD-FEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40845","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF0","description":"ICD-GDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA21","description":"ICD-3CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9757","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA1","description":"ICD-OCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9818","description":"HCPCS-C9818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0672","description":"Pressure pneum appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7009","description":"Adult electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diet counsel at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9474","description":"Diet counsel at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conz of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57461","description":"Conz of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF1","description":"ICD-GBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD151","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB1","description":"ICD-GCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE0","description":"ICD-GCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0706T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Split flat caliper stirr & p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2230","description":"Split flat caliper stirr & p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Comprehensive Platelet Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274U","description":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Comprehensive Platelet Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27734","description":"Repair lower leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0316","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE0","description":"ICD-LBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93981","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76987","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE0","description":"ICD-KCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB1","description":"ICD-NJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD1","description":"ICD-GARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vbac care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59614","description":"Vbac care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF0","description":"ICD-JAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD1","description":"ICD-OLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4B","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD1","description":"ICD-NFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0804T","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/renal strict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52346","description":"Cystouretero w/renal strict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"After cataract laser surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66821","description":"After cataract laser surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD0","description":"ICD-GARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emer response sys instal&tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5160","description":"Emer response sys instal&tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2C","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special med equip_ noswaiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2029","description":"Special med equip_ noswaiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF1","description":"ICD-JGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB1","description":"ICD-CBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect shoulder tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23078","description":"Resect shoulder tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA34","description":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF0","description":"ICD-JFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB0","description":"ICD-CCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD1","description":"ICD-CBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF0","description":"ICD-NGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC1","description":"ICD-MFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31084","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF1","description":"ICD-CAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9894","description":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF1","description":"ICD-IEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF0","description":"ICD-CGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9488","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF1","description":"ICD-KFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF1","description":"ICD-MAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA113","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92549","description":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA06","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE0","description":"ICD-DERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (sandoz)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9074","description":"Injection_ cyclophosphamide (sandoz)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78803","description":"Tumor imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC0","description":"ICD-FIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce shoulder bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23491","description":"Reinforce shoulder bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"deep sedation/general anesthesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9223","description":"deep sedation/general anesthesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC1","description":"ICD-CCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1259","description":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD212","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1220","description":"Anterior thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD1","description":"ICD-HFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA1","description":"ICD-GFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA1","description":"ICD-GIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC0","description":"ICD-AHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9269","description":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA0","description":"ICD-FDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC0","description":"ICD-OHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE0","description":"ICD-NCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation nasal sinus artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30915","description":"Ligation nasal sinus artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE1","description":"ICD-IFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE0","description":"ICD-JGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalist visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0310","description":"Hospitalist visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99453","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF1","description":"ICD-BANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0251U","description":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reticulated platelet assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85055","description":"Reticulated platelet assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD1","description":"ICD-KCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair standard detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1140","description":"Wheelchair standard detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology colorectal scr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81528","description":"Oncology colorectal scr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB1","description":"ICD-GCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF0","description":"ICD-FGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF0","description":"ICD-OHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD0","description":"ICD-NHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA1","description":"ICD-GFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD201","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0664U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0664U","description":"CPT-0664U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27358","description":"Remove femur lesion/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tendon for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20924","description":"Removal of tendon for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE0","description":"ICD-OJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gemcitabine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9201","description":"Gemcitabine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB1","description":"ICD-IGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF1","description":"ICD-BCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52318","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn pt cath >=90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9266","description":"Norsn pt cath >=90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0587U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","description":"CPT-0587U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No urtr inj at surg/1ms post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9633","description":"No urtr inj at surg/1ms post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brca1&2 seq & full dup/del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81162","description":"Brca1&2 seq & full dup/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF1","description":"ICD-CBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA1","description":"ICD-GCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay duodenal fluid trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84485","description":"Assay duodenal fluid trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME1","description":"ICD-FHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC0","description":"ICD-CDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28292","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC1","description":"ICD-NDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF0","description":"ICD-CEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA1","description":"ICD-ODVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35231","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam one surface permanen","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2140","description":"Amalgam one surface permanen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq device breast ea imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19282","description":"Perq device breast ea imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE1","description":"ICD-GFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93224","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89346","description":"Storage/year oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA1","description":"ICD-KEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-86581","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","description":"CPT-86581","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC0","description":"ICD-OJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in water/salne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6230","description":"Gauze > 48 sq in water/salne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC0","description":"ICD-JGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE0","description":"ICD-DCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE144","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC1","description":"ICD-HDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42892","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD0","description":"ICD-GEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB0","description":"ICD-GIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73620","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC24","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA0","description":"ICD-MLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE0","description":"ICD-HIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Empiric antibiotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4045F","description":"Empiric antibiotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA55","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED1","description":"ICD-CCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19084","description":"Bx breast add lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD0","description":"ICD-MHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC0","description":"ICD-KAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv musc migraine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64615","description":"Chemodenerv musc migraine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE1","description":"ICD-NKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15999","description":"Removal of pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8656","description":"Fun stat score le < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC1","description":"ICD-OFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55725","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA0","description":"ICD-NBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB1","description":"ICD-FHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45400","description":"Laparoscopic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transtracheal oxygen cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4608","description":"Transtracheal oxygen cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA0","description":"ICD-HASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC216","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA1","description":"ICD-GHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 16 & >","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88189","description":"Flowcytometry/read 16 & >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ranitidine hydrochloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2780","description":"Ranitidine hydrochloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE0","description":"ICD-EIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF0","description":"ICD-IALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE1","description":"ICD-CICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE1","description":"ICD-JADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE0","description":"ICD-AHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC1","description":"ICD-KAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC0","description":"ICD-KBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE1","description":"ICD-PGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","description":"HCPCS-J3402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB0","description":"ICD-BHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE213","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD1","description":"ICD-EBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB1","description":"ICD-MBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF0","description":"ICD-GFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72132","description":"Ct lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB141","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE1","description":"ICD-JHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC1","description":"ICD-LCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF1","description":"ICD-NBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33213","description":"Insert pulse gen dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA36","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB0","description":"ICD-MEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of pancreas open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48100","description":"Biopsy of pancreas open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC0","description":"ICD-GAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2073","description":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD0","description":"ICD-IEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE0","description":"ICD-CCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB1","description":"ICD-NCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA0","description":"ICD-ADLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4300F","description":"Pt rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD1","description":"ICD-NGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0574U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","description":"CPT-0574U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC0","description":"ICD-ODIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12032","description":"Intmd rpr s/a/t/ext 2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reposition venous catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36597","description":"Reposition venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24566","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC1","description":"ICD-EHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toe loop/holder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0952","description":"Toe loop/holder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC0","description":"ICD-MDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF1","description":"ICD-OHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj calcitriol per 0.1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0636","description":"Inj calcitriol per 0.1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2118","description":"Lens aniseikonic single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF1","description":"ICD-OAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC136","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL35","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7658","description":"Isoproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9597","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group health education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99078","description":"Group health education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF0","description":"ICD-NGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA0","description":"ICD-NBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF1","description":"ICD-OAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2103","description":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD1","description":"ICD-GBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429U","description":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc rect tum transanal full","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45172","description":"Exc rect tum transanal full","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38102","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (rykindo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2801","description":"Injection_ risperidone (rykindo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of sexual activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9818","description":"Documentation of sexual activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-phospholipid antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86148","description":"Anti-phospholipid antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA1","description":"ICD-OEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE1","description":"ICD-DGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Basic life support mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0380","description":"Basic life support mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No reason for no hep c geno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9208","description":"No reason for no hep c geno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay total hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83505","description":"Assay total hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB0","description":"ICD-HGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF1","description":"ICD-AGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1097T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1097T","description":"CPT-1097T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","description":"HCPCS-Q4390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue and neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41135","description":"Tongue and neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB0","description":"ICD-MATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA1","description":"ICD-DERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA14","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC1","description":"ICD-MBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC0","description":"ICD-KIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56605","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC0","description":"ICD-HDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0502","description":"CDT-D0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB0","description":"ICD-KBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB1","description":"ICD-OHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA1","description":"ICD-HGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nutritional support offered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4551F","description":"Nutritional support offered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB0","description":"ICD-OHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2123","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0918T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","description":"CPT-0918T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD0","description":"ICD-KGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB1","description":"ICD-MFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF0","description":"ICD-HEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1045","description":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF1","description":"ICD-EFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone a inj prs-free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3300","description":"Triamcinolone a inj prs-free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE0","description":"ICD-KCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC1","description":"ICD-ABHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no hx act drain 90 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8562","description":"Pt no hx act drain 90 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF0","description":"ICD-OEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68320","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD0","description":"ICD-KEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0381","description":"Cone beam ct capt mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA0","description":"ICD-OEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29044","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE1","description":"ICD-NCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00148","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","description":"CPT-00148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2193","description":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC0","description":"ICD-KBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21651","description":"Anesth head vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA1","description":"ICD-EIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67908","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant artery each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35697","description":"Reimplant artery each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF1","description":"ICD-PGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB0","description":"ICD-MEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pouch absorbent material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4422","description":"Ost pouch absorbent material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0686T","description":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath mtral vlve repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345T","description":"Transcath mtral vlve repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML36","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6035","description":"Gold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43320","description":"Fuse esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB1","description":"ICD-JEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61520","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF1","description":"ICD-MIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00322","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","description":"CPT-00322","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88323","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD0","description":"ICD-IHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0615","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4209","description":"Surgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7647","description":"Isoetharine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD0","description":"ICD-CBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gluc monitor rental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1031","description":"Gluc monitor rental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exemestane_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0156","description":"Exemestane_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD0","description":"ICD-IADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA1","description":"ICD-NLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD0","description":"ICD-MALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb subq tissue add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11045","description":"Deb subq tissue add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endo perq dx w/speci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47552","description":"Biliary endo perq dx w/speci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gel cap for trach voice pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8512","description":"Gel cap for trach voice pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA0","description":"ICD-CHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palliative care services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1309","description":"Palliative care services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC1","description":"ICD-JEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add joint upper ext orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3956","description":"Add joint upper ext orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 2 or 3 stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0341","description":"Lifestyle mod 2 or 3 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32994","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0502","description":"HCPCS-C0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA0","description":"ICD-CBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smear complex stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87209","description":"Smear complex stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB111","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23473","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB1","description":"ICD-BADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF1","description":"ICD-OCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b or 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9114","description":"Onc dx ovarian stg1a-b or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat interm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77762","description":"Apply intrcav radiat interm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD156","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4C","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID0","description":"ICD-BBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB1","description":"ICD-CHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE1","description":"ICD-GHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED0","description":"ICD-JIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE0","description":"ICD-KGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE1","description":"ICD-MGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC1","description":"ICD-OLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain bladder by needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51100","description":"Drain bladder by needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA31","description":"ICD-1AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB1","description":"ICD-KFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF1","description":"ICD-KBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5422","description":"Dentures adjust part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD0","description":"ICD-MAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB204","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD1","description":"ICD-OHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA114","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent BP is less than or equal to 140/90 mm Hg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9788","description":"Most recent BP is less than or equal to 140/90 mm Hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9282","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","description":"HCPCS-J9282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD1","description":"ICD-IIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA0","description":"ICD-FEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA0","description":"ICD-IAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA0","description":"ICD-GCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD1","description":"ICD-GASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB1","description":"ICD-KHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53454","description":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35190","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hinge extension/flex wrist/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3900","description":"Hinge extension/flex wrist/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay synovial fluid mucin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83872","description":"Assay synovial fluid mucin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87531","description":"Hhv-6 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE1","description":"ICD-CBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA126","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES201","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC1","description":"ICD-MCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD1","description":"ICD-BHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cuvitru)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1555","description":"Injection_ immune globulin (Cuvitru)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drive wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2394","description":"Drive wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE1","description":"ICD-MJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF1","description":"ICD-NAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF1","description":"ICD-FDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA1","description":"ICD-JEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21920","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE0","description":"ICD-KAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB1","description":"ICD-BACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD0","description":"ICD-KIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD0","description":"ICD-KIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD0","description":"ICD-MKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC0","description":"ICD-PFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87490","description":"Chylmd trach dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 5MCG/0.5ML AS03","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91310","description":"SARSCOV2 VAC 5MCG/0.5ML AS03","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advncd care plan 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99497","description":"Advncd care plan 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228U","description":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA21","description":"ICD-2KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB1","description":"ICD-KAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA56","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stat lab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3600","description":"Stat lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB1","description":"ICD-NHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE0","description":"ICD-FCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1801","description":"HCPCS-B1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD0","description":"ICD-FBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB1","description":"ICD-MABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74455","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98972","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infrared ht sys replcmnt pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4639","description":"Infrared ht sys replcmnt pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF0","description":"ICD-JALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC1","description":"ICD-BFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28022","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77770","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC0","description":"ICD-OCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB1","description":"ICD-DBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD224","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA0","description":"ICD-JHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recon_ cta for surg plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0288","description":"Recon_ cta for surg plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD0","description":"ICD-EATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB0","description":"ICD-NIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE0","description":"ICD-GEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA0","description":"ICD-BICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63017","description":"Remove spine lamina >2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tap block bi by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64489","description":"Tap block bi by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA0","description":"ICD-MEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0025U","description":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF0","description":"ICD-MJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c 100-129 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3049F","description":"Ldl-c 100-129 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29895","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL10","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC1","description":"ICD-NGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nondisposable nebulizer set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7005","description":"Nondisposable nebulizer set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD0","description":"ICD-OBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA1","description":"ICD-CIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27499","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB1","description":"ICD-NKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB0","description":"ICD-FAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF0","description":"ICD-PIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD0","description":"ICD-ECLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC21","description":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44661","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9802","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB0","description":"ICD-OKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coping","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2975","description":"Coping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD1","description":"ICD-CAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27200","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD1","description":"ICD-KCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA42","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD0","description":"ICD-EITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB0","description":"ICD-AHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Event recorder_ cardiac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1764","description":"Event recorder_ cardiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD0","description":"ICD-LFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE0","description":"ICD-KAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand/chin ctrl spec joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2373","description":"Hand/chin ctrl spec joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC1","description":"ICD-OGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99245","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21127","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB0","description":"ICD-IBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF0","description":"ICD-BIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB0","description":"ICD-LEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB0","description":"ICD-OCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC0","description":"ICD-OLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lead pace-defib one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33218","description":"Repair lead pace-defib one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72126","description":"Ct neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF1","description":"ICD-GHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB1","description":"ICD-HDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA1","description":"ICD-PLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD0","description":"ICD-NEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD0","description":"ICD-NFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC1","description":"ICD-KAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2048","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2048","description":"HCPCS-A2048","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0904T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","description":"CPT-0904T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","description":"CPT-01756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home vent invasive interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0465","description":"Home vent invasive interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA0","description":"ICD-BEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD140","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF0","description":"ICD-KIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD0","description":"ICD-OBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth trach-bronch reconst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53951","description":"Anesth trach-bronch reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD0","description":"ICD-HBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diab manage trn ind/group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0109","description":"Diab manage trn ind/group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc tempory vessel occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61623","description":"Endovasc tempory vessel occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA0","description":"ICD-KCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA1","description":"ICD-MKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22841","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recomb novoeight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7182","description":"Factor viii recomb novoeight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental coronoidectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7991","description":"Dental coronoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3028F","description":"O2 saturation doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64718","description":"Revise ulnar nerve at elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1302","description":"HCPCS-B1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal biophys profile w/nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76818","description":"Fetal biophys profile w/nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB1","description":"ICD-GHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE0","description":"ICD-BCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC1","description":"ICD-JDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC31","description":"ICD-2LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF1","description":"ICD-BHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB1","description":"ICD-KHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE0","description":"ICD-PJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA0","description":"ICD-OIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA1","description":"ICD-OKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9370","description":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nurse practr visit outs cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0274","description":"Nurse practr visit outs cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA0","description":"ICD-OLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD0","description":"ICD-AIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF0","description":"ICD-BBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF1","description":"ICD-JCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC0","description":"ICD-FHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor renal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50325","description":"Prep donor renal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD1","description":"ICD-DFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA1","description":"ICD-NCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD1","description":"ICD-FBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing upright w/ adjust s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1920","description":"Afo sing upright w/ adjust s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens pmma color vision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2503","description":"Cntct lens pmma color vision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE0","description":"ICD-JEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE1","description":"ICD-OKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90739","description":"Hepb vacc 2 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA0","description":"ICD-AHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA0","description":"ICD-CENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE1","description":"ICD-GHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62147","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE0","description":"ICD-GFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB1","description":"ICD-JDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA0","description":"ICD-IFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not all data norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9324","description":"Not all data norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD256","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0682","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","description":"HCPCS-G0682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD1","description":"ICD-OCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","description":"HCPCS-J0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","description":"HCPCS-A6516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Co57/58","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9546","description":"Co57/58","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2112","description":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Snrpn/ube3a gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81331","description":"Snrpn/ube3a gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red cell sequestration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78140","description":"Red cell sequestration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC1","description":"ICD-IABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0590U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","description":"CPT-0590U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated resin crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2932","description":"Prefabricated resin crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31614","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70551","description":"MRI brain stem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CoreText or ProText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4246","description":"CoreText or ProText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC0","description":"ICD-BHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB1","description":"ICD-BFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC32","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40525","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23616","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB0","description":"ICD-GFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy infusion method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96425","description":"Chemotherapy infusion method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE0","description":"ICD-IHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC1","description":"ICD-AIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA0","description":"ICD-GFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB0","description":"ICD-FDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0077","description":"Injection_ clindamycin phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD0","description":"ICD-MHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB12","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD1","description":"ICD-IGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46606","description":"Anoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA0","description":"ICD-KGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE120","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD1","description":"ICD-MKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46730","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE0","description":"ICD-OFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45120","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31760","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD1","description":"ICD-NCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1086","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD0","description":"ICD-KAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N blk inj sciatic cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64446","description":"N blk inj sciatic cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF0","description":"ICD-KBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Col chromotography qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82542","description":"Col chromotography qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluocinolone acetonide implt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7311","description":"Fluocinolone acetonide implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE1","description":"ICD-BCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF0","description":"ICD-PCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA0","description":"ICD-BIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0602U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","description":"CPT-0602U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of caries arresting medicament-per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1354","description":"Application of caries arresting medicament-per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES234","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC1","description":"ICD-FGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8F","description":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB1","description":"ICD-FEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF0","description":"ICD-ECHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2083","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1292","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA1","description":"ICD-OHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD0","description":"ICD-JIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67430","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA1","description":"ICD-GHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD1","description":"ICD-OLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE1","description":"ICD-GFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC0","description":"ICD-OAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA1","description":"ICD-GGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27496","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB1","description":"ICD-JGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE1","description":"ICD-KIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE0","description":"ICD-OLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB0","description":"ICD-GFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME0","description":"ICD-IDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE1","description":"ICD-CBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beclomethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7622","description":"Beclomethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB0","description":"ICD-CAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD1","description":"ICD-CACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC0","description":"ICD-FAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0671U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671U","description":"CPT-0671U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA41","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA1","description":"ICD-NBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF0","description":"ICD-NGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99396","description":"Prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61540","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA0","description":"ICD-NIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA1","description":"ICD-JAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA0","description":"ICD-PIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF0","description":"ICD-OFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF0","description":"ICD-OIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA0","description":"ICD-NDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF1","description":"ICD-MFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA1","description":"ICD-NHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB0","description":"ICD-GCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD0","description":"ICD-KETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC1","description":"ICD-AHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v interpret","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88141","description":"Cytopath c/v interpret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB0","description":"ICD-GCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34703","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC0","description":"ICD-LCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF0","description":"ICD-FAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF0","description":"ICD-JGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC1","description":"ICD-NFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23480","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25624","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcyte_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4182","description":"Transcyte_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE1","description":"ICD-PCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE1","description":"ICD-HIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD1","description":"ICD-KFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0601","description":"Repl batt silver oxide 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23485","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC1","description":"ICD-MCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1028","description":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB0","description":"ICD-GAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0564","description":"HCPCS-G0564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD0","description":"ICD-IEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth anorectal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90251","description":"Anesth anorectal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65220","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD1","description":"ICD-CEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23071","description":"Exc shoulder les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0248","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50948","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD1","description":"ICD-LGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB0","description":"ICD-NHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD1","description":"ICD-OISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA0","description":"ICD-OKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA1","description":"ICD-BBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD1","description":"ICD-OJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB0","description":"ICD-LAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4283","description":"Auto tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ovarian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58752","description":"Revise ovarian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99343","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF1","description":"ICD-NHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB0","description":"ICD-GESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA0","description":"ICD-GHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0D","description":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE1","description":"ICD-NDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB0","description":"ICD-CEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12013","description":"Rpr f/e/e/n/l/m 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF1","description":"ICD-NJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE1","description":"ICD-BIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA0","description":"ICD-OBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC0","description":"ICD-NHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE1","description":"ICD-KIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF0","description":"ICD-FAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nucleotidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83915","description":"Assay of nucleotidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20206","description":"Needle biopsy muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD0","description":"ICD-CDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy revise stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31638","description":"Bronchoscopy revise stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC1","description":"ICD-GBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC0","description":"ICD-MBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB1","description":"ICD-OEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF0","description":"ICD-KEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust ankle ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1815","description":"Adjust ankle ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB01","description":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD1","description":"ICD-JEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0040","description":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs ext/flex a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3730","description":"Forearm/arm cuffs ext/flex a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE0","description":"ICD-KITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transpl allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48554","description":"Transpl allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1517","description":"Space maintainer_ fixed_ bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37222","description":"Iliac revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj ferric carboxymaltos 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1439","description":"Inj ferric carboxymaltos 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE0","description":"ICD-OAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF1","description":"ICD-NJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stainless steel crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2933","description":"Prefab stainless steel crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1021T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","description":"CPT-1021T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7540","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE0","description":"ICD-HHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58800","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB1","description":"ICD-EGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o preop order iv ab pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8918","description":"Pt w/o preop order iv ab pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE1","description":"ICD-OHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1598","description":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic 2nd+ inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64462","description":"Pvb thoracic 2nd+ inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD1","description":"ICD-BCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB0","description":"ICD-HBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA1","description":"ICD-JHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE1","description":"ICD-PEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9749","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD0","description":"ICD-GFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grad comp non-elastic bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6545","description":"Grad comp non-elastic bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD0","description":"ICD-IHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED0","description":"ICD-IDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7877","description":"Tmj arthroscopy debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0842","description":"Pwc gp2 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Streptokinase antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86590","description":"Streptokinase antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD121","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1001","description":"HCPCS-B1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB0","description":"ICD-HDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58952","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev_ sport/rec/work att","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6704","description":"Term dev_ sport/rec/work att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC1","description":"ICD-MATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp unt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7629","description":"Bitolterol mesylate comp unt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prolactin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84146","description":"Assay of prolactin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg review and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298T","description":"Ext ecg review and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC1","description":"ICD-NJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9317","description":"Injection_ sacituzumab govitecan-hziy_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC1","description":"ICD-GFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breath tst attain/anal c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78267","description":"Breath tst attain/anal c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43192","description":"Esophagoscp rig trnso inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC1","description":"ICD-KDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB0","description":"ICD-KCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55709","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","description":"CPT-55709","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD0","description":"ICD-GFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB0","description":"ICD-IDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43100","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2107","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME1","description":"ICD-OFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB0","description":"ICD-FGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face tum deep < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21013","description":"Exc face tum deep < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10060","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82043","description":"Albumin; urine (eg_ microalbumin)_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC0","description":"ICD-OEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70559","description":"MRI brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA1","description":"ICD-HCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB11","description":"ICD-3HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA1","description":"ICD-FFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF0","description":"ICD-CGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE0","description":"ICD-NLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyurea 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0176","description":"Hydroxyurea 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND0","description":"ICD-JBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD0","description":"ICD-CDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB1","description":"ICD-NANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1C","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88304","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19380","description":"Revise breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc taa repr incl subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33880","description":"Endovasc taa repr incl subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59841","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC0","description":"ICD-PEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release spinal cord lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63200","description":"Release spinal cord lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58562","description":"Hysteroscopy remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME0","description":"ICD-MGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso and shoulder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6568","description":"Gradient compression garment_ torso and shoulder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27332","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma stage i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9128","description":"Onc dx multi myeloma stage i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA1","description":"ICD-IDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD1","description":"ICD-FDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC0","description":"ICD-FBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0515","description":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD1","description":"ICD-FCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC1","description":"ICD-JCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID0","description":"ICD-NHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram one breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77055","description":"Mammogram one breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dist revas ligation hemo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36838","description":"Dist revas ligation hemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Larynscop remve cart + scop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31561","description":"Larynscop remve cart + scop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA15","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32852","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0014","description":"HCPCS-J0014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"T cell absolute count/ratio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86360","description":"T cell absolute count/ratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3209","description":"Surgical boot each child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4032","description":"Cast sup lng leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF0","description":"ICD-JFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC0","description":"ICD-OJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB1","description":"ICD-CFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44715","description":"Prepare donor intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC0","description":"ICD-MIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF1","description":"ICD-OADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA1","description":"ICD-JDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB0","description":"ICD-CBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA0","description":"ICD-CICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB0","description":"ICD-GGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6713","description":"Ped term dev_ hand_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD1","description":"ICD-OILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017M","description":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF0","description":"ICD-PJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF1","description":"ICD-NFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hpv low-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87623","description":"Hpv low-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA0","description":"ICD-PGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF0","description":"ICD-BDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA1","description":"ICD-JFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81319","description":"Pms2 gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD1","description":"ICD-OBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD1","description":"ICD-NCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7503","description":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD1","description":"ICD-PFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc a aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4020","description":"Ivf canc a aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ingest challenge addl 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95079","description":"Ingest challenge addl 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB0","description":"ICD-OLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA0","description":"ICD-OENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30115","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lifts elevation metal extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3330","description":"Lifts elevation metal extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97550","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film >16<=48 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6258","description":"Transparent film >16<=48 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA32","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB1","description":"ICD-KIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE1","description":"ICD-CFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC1","description":"ICD-JBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE1","description":"ICD-BETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC0","description":"ICD-IBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50040","description":"Drainage of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC1","description":"ICD-NFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power bone marrow bx needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1830","description":"Power bone marrow bx needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54332","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81354","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","description":"CPT-81354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92537","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF1","description":"ICD-EFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA1","description":"ICD-GFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc99m arcitumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9568","description":"Technetium tc99m arcitumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF0","description":"ICD-KANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB0","description":"ICD-HHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA0","description":"ICD-OLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC0","description":"ICD-MEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA0","description":"ICD-FEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nickel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83885","description":"Assay of nickel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD1","description":"ICD-MCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA1","description":"ICD-MKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap ileo/jejuno-stomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44187","description":"Lap ileo/jejuno-stomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF0","description":"ICD-OBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF0","description":"ICD-KGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice/home hlth in asst lv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5002","description":"Hospice/home hlth in asst lv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Image test ref carot diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3100F","description":"Image test ref carot diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF0","description":"ICD-DBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF1","description":"ICD-CEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD1","description":"ICD-OIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36466","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD255","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA1","description":"ICD-KCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF1","description":"ICD-IETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD1","description":"ICD-JDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC45","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj pantoprazole sodium_ via","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9113","description":"Inj pantoprazole sodium_ via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue hard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7285","description":"Biopsy of oral tissue hard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC1","description":"ICD-CCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43238","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0650U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0650U","description":"CPT-0650U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1228","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC250","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heavyduty walker no wheels","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0148","description":"Heavyduty walker no wheels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81258","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 antibody testing of or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3645","description":"Hiv-1 antibody testing of or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95991","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65860","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE0","description":"ICD-LCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD1","description":"ICD-IBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE0","description":"ICD-BBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5926","description":"Replacement nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD0","description":"ICD-CBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68040","description":"Treatment of eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF1","description":"ICD-FCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60522","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB1","description":"ICD-FBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF1","description":"ICD-IIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specimen handling pt-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99001","description":"Specimen handling pt-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41016","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD1","description":"ICD-NIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3C","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29876","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE0","description":"ICD-FGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC1","description":"ICD-NJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF0","description":"ICD-IFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA1","description":"ICD-BELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4245","description":"AmnioText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA0","description":"ICD-KBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC1","description":"ICD-MBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36555","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2064","description":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplants of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27397","description":"Transplants of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","description":"CPT-01212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","description":"HCPCS-A9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2103","description":"Adrenal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28102","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of zinc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84630","description":"Assay of zinc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC1","description":"ICD-GEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF1","description":"ICD-EDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF0","description":"ICD-NFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28043","description":"Exc foot/toe tum sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE0","description":"ICD-JHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD0","description":"ICD-MLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD215","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt max lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5750","description":"Denture reln cmplt max lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC0","description":"ICD-OBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52310","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA0","description":"ICD-BCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q6h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9503","description":"Hit antibiotic q6h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA0","description":"ICD-ODQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33020","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","description":"HCPCS-J0163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10006","description":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2102","description":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA0","description":"ICD-NEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE0","description":"ICD-CCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC1","description":"ICD-IICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27722","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1088","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31255","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC1","description":"ICD-EFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dornase alfa non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7639","description":"Dornase alfa non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD1","description":"ICD-KEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57265","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF1","description":"ICD-BDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF0","description":"ICD-IFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guide cathet fluid drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10030","description":"Guide cathet fluid drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1007","description":"HCPCS-L1007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX01","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forehead flap w/vasc pedicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15731","description":"Forehead flap w/vasc pedicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA1","description":"ICD-GFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1323","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE0","description":"ICD-MGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1215","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Up ext fx orthos humeral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3980","description":"Up ext fx orthos humeral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID1","description":"ICD-MBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24110","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost a/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7404","description":"Add ue prost a/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF0","description":"ICD-CIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD0","description":"ICD-KFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25375","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB0","description":"ICD-MAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a normal neurological examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9535","description":"Patients with a normal neurological examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric derisomaltose_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1437","description":"Injection_ ferric derisomaltose_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Holster elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0498","description":"Holster elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38380","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354U","description":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29015","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD0","description":"ICD-BBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE0","description":"ICD-GBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB1","description":"ICD-EBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stress mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9454","description":"Stress mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42000","description":"Drainage mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kyphosis pad floating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1025","description":"Kyphosis pad floating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA1","description":"ICD-GIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add metal substructure to acrylic full denture (per arch)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5876","description":"Add metal substructure to acrylic full denture (per arch)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB0","description":"ICD-EIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF1","description":"ICD-OLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE0","description":"ICD-KGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF1","description":"ICD-OEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9583","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise external hemorrhoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46083","description":"Incise external hemorrhoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB0","description":"ICD-CGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0482T","description":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD1","description":"ICD-KAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leishmania antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86717","description":"Leishmania antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX44","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE0","description":"ICD-OHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA0","description":"ICD-NGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA1","description":"ICD-GGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD0","description":"ICD-CGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB0","description":"ICD-KGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stress tte only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93350","description":"Stress tte only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE0","description":"ICD-ADLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF0","description":"ICD-GANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mis sup/acc imp vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0508","description":"Mis sup/acc imp vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA1","description":"ICD-JCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE1","description":"ICD-BGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA0","description":"ICD-OLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA0","description":"ICD-OAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0030","description":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA0","description":"ICD-FDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image spect sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78451","description":"Ht muscle image spect sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB1","description":"ICD-NLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA1","description":"ICD-GDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tenoglide tendon prot_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9356","description":"Tenoglide tendon prot_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB1","description":"ICD-CGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA1","description":"ICD-NGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of low back nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64862","description":"Repair of low back nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exchange biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47536","description":"Exchange biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43338","description":"Esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF0","description":"ICD-FBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collect & prep genetic samp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0422","description":"Collect & prep genetic samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27350","description":"Removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compress burn mask face/neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6513","description":"Compress burn mask face/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76827","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB1","description":"ICD-AITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC1","description":"ICD-IGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attendant care service /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5125","description":"Attendant care service /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96171","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no adeno/neopl detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9496","description":"Doc rsn no adeno/neopl detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB03","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA16","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC0","description":"ICD-GFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME0","description":"ICD-NJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD1","description":"ICD-MADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA1","description":"ICD-OFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB1","description":"ICD-OJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of aqueous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66184","description":"Revision of aqueous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74475","description":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD1","description":"ICD-HFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC0","description":"ICD-ODAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9539","description":"Tc99m pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME1","description":"ICD-OHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB1","description":"ICD-ECIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4021","description":"Cast sup sht arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC1","description":"ICD-NCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC1","description":"ICD-EFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear protector evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92596","description":"Ear protector evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","description":"HCPCS-A9154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA0","description":"ICD-OLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m disofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9510","description":"Tc99m disofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Persist asthma medicine ctrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4015F","description":"Persist asthma medicine ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0831","description":"Pwc gp2 std seat elevate cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA1","description":"ICD-OLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB21","description":"ICD-3BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1490","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","description":"HCPCS-M1490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF0","description":"ICD-KGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obinutuzumab inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9301","description":"Obinutuzumab inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC0","description":"ICD-FIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA1","description":"ICD-KDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23600","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty rest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4212","description":"Gingivectomy/plasty rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49580","description":"Rpr umbil hern reduc < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF0","description":"ICD-GBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF0","description":"ICD-OIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC1","description":"ICD-JIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE1","description":"ICD-JACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE0","description":"ICD-JAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1071","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME0","description":"ICD-NEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB1","description":"ICD-OCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endocrine nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78099","description":"Endocrine nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27846","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB0","description":"ICD-OJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC0","description":"ICD-PIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC1","description":"ICD-BHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27095","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB1","description":"ICD-CHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA1","description":"ICD-FAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC0","description":"ICD-NDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC0","description":"ICD-NJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB1","description":"ICD-KBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix repair bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57556","description":"Remove cervix repair bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB0","description":"ICD-OIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35907","description":"Excision graft abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD1","description":"ICD-OFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA0","description":"ICD-HGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA1","description":"ICD-CBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9312","description":"Injection_ rituximab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37251","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA1","description":"ICD-GDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reshaping bone orthognathic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7940","description":"Reshaping bone orthognathic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99153","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0558","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","description":"HCPCS-G0558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE0","description":"ICD-CAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder over 12.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2114","description":"Spherocylinder over 12.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB0","description":"ICD-IAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med txmnt options rvwd w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4325F","description":"Med txmnt options rvwd w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE1","description":"ICD-OJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC1","description":"ICD-MLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9326","description":"Norsn no ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene intron poly t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81224","description":"Cftr gene intron poly t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56151","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF0","description":"ICD-BCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB1","description":"ICD-GFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conn tiss_ non-human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1763","description":"Conn tiss_ non-human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8720","description":"HCPCS-L8720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC0","description":"ICD-FCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB1","description":"ICD-GITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB1","description":"ICD-BCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA1","description":"ICD-BGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF1","description":"ICD-BCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Card MRI w/stress img & dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75563","description":"Card MRI w/stress img & dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone pellet 75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0189","description":"Testosterone pellet 75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth blepharoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10351","description":"Anesth blepharoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC1","description":"ICD-HAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB0","description":"ICD-CGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF0","description":"ICD-MJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA31","description":"ICD-2BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA1","description":"ICD-GINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1468","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","description":"HCPCS-M1468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF1","description":"ICD-DBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE1","description":"ICD-EDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD0","description":"ICD-JFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Belimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0490","description":"Belimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC0","description":"ICD-CDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC0","description":"ICD-JBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF1","description":"ICD-OHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serv asmnt/care plan waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2024","description":"Serv asmnt/care plan waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF0","description":"ICD-KICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC54","description":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1403","description":"HCPCS-B1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD1","description":"ICD-PCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE1","description":"ICD-GHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC0","description":"ICD-KHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD1","description":"ICD-GGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF0","description":"ICD-HBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy control bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46614","description":"Anoscopy control bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA1","description":"ICD-OBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Used By Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9992","description":"Palliative Care Services Used By Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE0","description":"ICD-FDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE0","description":"ICD-NCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95975","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexrazoxane hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1190","description":"Dexrazoxane hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","description":"HCPCS-Q4438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB256","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2mod symphis-xipho pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0458","description":"Tlso 2mod symphis-xipho pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC21","description":"ICD-4KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8X","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Design mlc device for imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77338","description":"Design mlc device for imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC1","description":"ICD-FBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC1","description":"ICD-FHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Driver pneumatic vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0480","description":"Driver pneumatic vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_Nivolumab_ 1mg (Opdivo)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9453","description":"Injection_Nivolumab_ 1mg (Opdivo)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA0","description":"ICD-NKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5227","description":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA0","description":"ICD-NAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5275","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB1","description":"ICD-CIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26850","description":"Fusion of knuckle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of scrotum abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55100","description":"Drainage of scrotum abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB0","description":"ICD-KFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD0","description":"ICD-NLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020M","description":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Swingaway detach footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0052","description":"Swingaway detach footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF0","description":"ICD-JENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA0","description":"ICD-EILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD1","description":"ICD-BBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE0","description":"ICD-MEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect apical lung tum/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32504","description":"Resect apical lung tum/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD0","description":"ICD-PCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA41","description":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain open abdom abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49040","description":"Drain open abdom abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0701","description":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oct brst/node i&r per spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352T","description":"Oct brst/node i&r per spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE1","description":"ICD-OLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA0","description":"ICD-ODYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD0","description":"ICD-NAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA0","description":"ICD-KAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE1","description":"ICD-IIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1101","description":"HCPCS-B1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0739","description":"Injection_ cabotegravir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB1","description":"ICD-HEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC0","description":"ICD-GBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81535","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0780T","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD1","description":"ICD-OLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9909","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing bar clasp attach sh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1910","description":"Afo sing bar clasp attach sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD1","description":"ICD-JEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bpci home visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9187","description":"Bpci home visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was referred to another provider or specialist during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9968","description":"Patient was referred to another provider or specialist during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eyelid lining surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68399","description":"Eyelid lining surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD0","description":"ICD-IABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD0","description":"ICD-DFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD1","description":"ICD-NGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj subq impltbl dfb elctrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33271","description":"Insj subq impltbl dfb elctrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1482","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","description":"HCPCS-M1482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA0","description":"ICD-PISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB1","description":"ICD-CBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF0","description":"ICD-BGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vessel mapping hemo access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0365","description":"Vessel mapping hemo access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduce testis torsion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54600","description":"Reduce testis torsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC1","description":"ICD-CDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0320","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8990","description":"Other pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6310","description":"Shoulder passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD1","description":"ICD-JEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1004","description":"HCPCS-B1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2246","description":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43130","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95929","description":"C motor evoked lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF1","description":"ICD-FDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","description":"CPT-01938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronch w/balloon occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31634","description":"Bronch w/balloon occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mh partial hosp tx under 24h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0035","description":"Mh partial hosp tx under 24h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collect & appl blood product","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7921","description":"Collect & appl blood product","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes ur alg rish urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012M","description":"ONC MRNA 5 genes ur alg rish urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA1","description":"ICD-BBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB1","description":"ICD-CEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27506","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92978","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE1","description":"ICD-BFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD0","description":"ICD-MECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0655T","description":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thorax spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22327","description":"Treat thorax spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrotestosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6047","description":"Dihydrotestosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectourethral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45820","description":"Repair rectourethral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA1","description":"ICD-EAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED1","description":"ICD-ABED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF0","description":"ICD-BFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1552","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA1","description":"ICD-JHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Belt/harness extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0945","description":"Belt/harness extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepagam b intravenous_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1573","description":"Hepagam b intravenous_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA0","description":"ICD-MKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB0","description":"ICD-OJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6196","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6196","description":"CDT-D6196","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB1","description":"ICD-AEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA1","description":"ICD-OGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80330","description":"Analgesics non-opioid 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC1","description":"ICD-BHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33277","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tum w/innom bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27077","description":"Resect hip tum w/innom bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF0","description":"ICD-MGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phospholipid pltlt neutraliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85597","description":"Phospholipid pltlt neutraliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD0","description":"ICD-KBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE1","description":"ICD-KCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0202","description":"HCPCS-C0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB1","description":"ICD-NBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA1","description":"ICD-CGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC21","description":"ICD-2KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF0","description":"ICD-FILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE0","description":"ICD-NKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA0","description":"ICD-EAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA1","description":"ICD-GGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum swg frc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5822","description":"Endo knee-shin pneum swg frc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF1","description":"ICD-NHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD1","description":"ICD-NBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD0","description":"ICD-JHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE0","description":"ICD-AHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA0","description":"ICD-IIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD1","description":"ICD-NHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41010","description":"Incision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9028","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE0","description":"ICD-LGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound filler gel/paste /oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6261","description":"Wound filler gel/paste /oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD1","description":"ICD-CBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7564","description":"HCPCS-C7564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA1","description":"ICD-PGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate biliary duct/ampulla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47542","description":"Dilate biliary duct/ampulla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA0","description":"ICD-OBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg coma or sleep only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95822","description":"Eeg coma or sleep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23400","description":"Fixation of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID0","description":"ICD-IAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB1","description":"ICD-KCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA1","description":"ICD-FGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte transformation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86353","description":"Lymphocyte transformation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5711","description":"Dentures rebase cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64653","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB1","description":"ICD-CAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE1","description":"ICD-MDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE1","description":"ICD-GEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo poly hip_ pneu/hyd/rot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5961","description":"Endo poly hip_ pneu/hyd/rot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC0","description":"ICD-MKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8I","description":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63090","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB210","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Renal scope w/tumor resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50562","description":"Renal scope w/tumor resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45130","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45317","description":"Proctosigmoidoscopy bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE0","description":"ICD-CASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80502","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD1","description":"ICD-JDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatic function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80076","description":"Hepatic function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","description":"CPT-81524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna vrl ld ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27043","description":"Exc hip pelvis les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD1","description":"ICD-IBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB0","description":"ICD-NAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA1","description":"ICD-OESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC0","description":"ICD-FIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult70","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0427","description":"Inpt/ed teleconsult70","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE1","description":"ICD-CCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of hand bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26230","description":"Partial removal of hand bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp fem-tibial peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35585","description":"Vein byp fem-tibial peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC0","description":"ICD-EFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0028U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA1","description":"ICD-KFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC0","description":"ICD-GESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB1","description":"ICD-CABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 quant&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87539","description":"Hiv-2 quant&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF0","description":"ICD-CDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND0","description":"ICD-NGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE1","description":"ICD-CFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE0","description":"ICD-MDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB1","description":"ICD-KITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC0","description":"ICD-OEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/lmph nod bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39402","description":"Mediastinoscpy w/lmph nod bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95148","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA1","description":"ICD-KBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE1","description":"ICD-KBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric bypass incl small i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43847","description":"Gastric bypass incl small i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31622","description":"Dx bronchoscope/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF1","description":"ICD-NCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54865","description":"Explore epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat uterus infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59830","description":"Treat uterus infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80375","description":"Drug/substance nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD0","description":"ICD-GGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33985","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB1","description":"ICD-KCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC1","description":"ICD-PJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE0","description":"ICD-OHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD0","description":"ICD-BBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB1","description":"ICD-CFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","description":"CPT-98016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE1","description":"ICD-GDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25915","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD1","description":"ICD-GGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eosinophil blood count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3630","description":"Eosinophil blood count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB0","description":"ICD-JAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF1","description":"ICD-ECHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE0","description":"ICD-AHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis east eqne anbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86652","description":"Encephaltis east eqne anbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arm pad each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0019","description":"Arm pad each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE0","description":"ICD-AAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE1","description":"ICD-FDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB1","description":"ICD-LIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB1","description":"ICD-KFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA11","description":"ICD-4IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intranasal reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30620","description":"Intranasal reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2D","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD0","description":"ICD-OFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC1","description":"ICD-CDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF0","description":"ICD-HERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7568","description":"HCPCS-C7568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE1","description":"ICD-BFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1551","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC1","description":"ICD-JAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69820","description":"Establish inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC1","description":"ICD-AIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24125","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diazoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1730","description":"Diazoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pemetrexed injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9305","description":"Pemetrexed injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED1","description":"ICD-NHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ROTAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87425","description":"IAAD IA ROTAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE1","description":"ICD-BBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND0","description":"ICD-BIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF1","description":"ICD-KIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD1","description":"ICD-MDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF0","description":"ICD-BBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi&small intest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74245","description":"X-ray upper gi&small intest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID0","description":"ICD-BEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","description":"HCPCS-Q4342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv tstng asked/docd/revwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3292F","description":"Hiv tstng asked/docd/revwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin recvd w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4084F","description":"Aspirin recvd w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC1","description":"ICD-EHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8939","description":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE0","description":"ICD-HBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13120","description":"Cmplx rpr s/a/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA1","description":"ICD-GBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4358","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","description":"HCPCS-Q4358","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC0","description":"ICD-PIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE1","description":"ICD-BIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC0","description":"ICD-BCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED0","description":"ICD-MDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor X_ (human)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7175","description":"Injection_ Factor X_ (human)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transverse aortic arch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33870","description":"Transverse aortic arch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/singl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33240","description":"Insrt pulse gen w/singl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA1","description":"ICD-NDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA1","description":"ICD-KENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE1","description":"ICD-GBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral nutrition additiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4216","description":"Parenteral nutrition additiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF0","description":"ICD-CBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA0","description":"ICD-PEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1049T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1049T","description":"CPT-1049T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE1","description":"ICD-OCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE1","description":"ICD-OLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80053","description":"Comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF1","description":"ICD-CIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB1","description":"ICD-ABTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC0","description":"ICD-EFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE0","description":"ICD-HGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE0","description":"ICD-ACCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF1","description":"ICD-NCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6563","description":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB1","description":"ICD-OCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1126","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF1","description":"ICD-GHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC1","description":"ICD-PEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frozen ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4016","description":"Frozen ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respite care service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1005","description":"Respite care service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF1","description":"ICD-FDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE0","description":"ICD-IGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9785","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB0","description":"ICD-BAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA0","description":"ICD-KHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD1","description":"ICD-MJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5256","description":"Hearing aid_ digit_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9038","description":"Rbc irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84295","description":"Assay of serum sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4052F","description":"Hemodialysis via av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c antiviral started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9205","description":"Hep c antiviral started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE0","description":"ICD-HASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC0","description":"ICD-GAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC0","description":"ICD-NJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","description":"HCPCS-M1371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB0","description":"ICD-MBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF0","description":"ICD-CBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esw wound healing init wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299T","description":"Esw wound healing init wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA1","description":"ICD-CAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA1","description":"ICD-EDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aldosterone suppression eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80408","description":"Aldosterone suppression eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA50","description":"Ultra High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove self-contd penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54415","description":"Remove self-contd penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF1","description":"ICD-LFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43500","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED0","description":"ICD-KEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE0","description":"ICD-ADBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infuse radioactive materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77750","description":"Infuse radioactive materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF0","description":"ICD-KBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9143","description":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA0","description":"ICD-KFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9479","description":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64454","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB1","description":"ICD-LCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE0","description":"ICD-HEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66630","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0569U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","description":"CPT-0569U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA0","description":"ICD-GDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA1","description":"ICD-PDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA0","description":"ICD-OBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pacemaker insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53051","description":"Anesth pacemaker insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w<3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6442","description":"Conform band n/s w<3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE0","description":"ICD-HAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC1","description":"ICD-GDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC1","description":"ICD-CBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE1","description":"ICD-KIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF1","description":"ICD-JIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC0","description":"ICD-JIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ 19 or few elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1730","description":"Cath_ ep_ 19 or few elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID0","description":"ICD-BFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE1","description":"ICD-JHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB0","description":"ICD-JBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/renal stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52343","description":"Cysto w/renal stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD1","description":"ICD-HGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB1","description":"ICD-CFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE0","description":"ICD-CDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevat legrst low extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0046","description":"Elevat legrst low extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE0","description":"ICD-FANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD0","description":"ICD-JCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair oviduct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58750","description":"Repair oviduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA0","description":"ICD-GHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB1","description":"ICD-KHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE0","description":"ICD-GCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE1","description":"ICD-BFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC1","description":"ICD-CGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB0","description":"ICD-FDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE1","description":"ICD-CHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusive eye patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6412","description":"Occlusive eye patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE0","description":"ICD-KAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","description":"CPT-98007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE1","description":"ICD-JGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA0","description":"ICD-ACDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE0","description":"ICD-IFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC0","description":"ICD-CBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB21","description":"ICD-3DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF0","description":"ICD-CCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11760","description":"Repair of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA1","description":"ICD-IFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-125 sodium iodide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9527","description":"Iodine i-125 sodium iodide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB1","description":"ICD-MJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA0","description":"ICD-BGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF0","description":"ICD-GCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Refill/maint pump/resvr syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96522","description":"Refill/maint pump/resvr syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF1","description":"ICD-JGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA0","description":"ICD-MJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC1","description":"ICD-FAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add felt w leath insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3520","description":"O shoe add felt w leath insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1805","description":"HCPCS-A1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF0","description":"ICD-CITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"General anesthesia_ first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9222","description":"General anesthesia_ first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB0","description":"ICD-OFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD0","description":"ICD-HAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC0","description":"ICD-OFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21423","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body adbomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49402","description":"Remove foreign body adbomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND0","description":"ICD-OCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3916","description":"Who nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88153","description":"Cytopath c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin cartridge 150 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5565","description":"Insulin cartridge 150 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21195","description":"Reconst lwr jaw w/o fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF1","description":"ICD-AAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD0","description":"ICD-LERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED1","description":"ICD-ICED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD1","description":"ICD-IDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43810","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD0","description":"ICD-FCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motion analysis video/3d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96000","description":"Motion analysis video/3d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sps forearm device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1818","description":"Sps forearm device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA1","description":"ICD-OITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary leg bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5112","description":"Urinary leg bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC210","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA11","description":"ICD-1HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB0","description":"ICD-IFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA0","description":"ICD-KHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0252U","description":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF1","description":"ICD-KBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE1","description":"ICD-FHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD216","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0B","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88199","description":"Cytopathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0668U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0668U","description":"CPT-0668U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE1","description":"ICD-BAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD0","description":"ICD-MLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75746","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE1","description":"ICD-MDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF1","description":"ICD-GCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0671","description":"Pressure pneum appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF1","description":"ICD-GFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME1","description":"ICD-CGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE1","description":"ICD-NFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA1","description":"ICD-NJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB150","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE0","description":"ICD-EFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery bypass/reop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33530","description":"Coronary artery bypass/reop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8H","description":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC0","description":"ICD-GEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB0","description":"ICD-GASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB0","description":"ICD-CDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC1","description":"ICD-EIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE1","description":"ICD-IBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD0","description":"ICD-GBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME0","description":"ICD-BHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA1","description":"ICD-CDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61891","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF1","description":"ICD-BHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33722","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE1","description":"ICD-ABDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk mold socket sach ft endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5301","description":"Bk mold socket sach ft endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC0","description":"ICD-PJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF0","description":"ICD-DGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF0","description":"ICD-NACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87481","description":"Candida dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0406","description":"HCPCS-C0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF0","description":"ICD-LBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC0","description":"ICD-LCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/balloon dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45386","description":"Colonoscopy w/balloon dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25450","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF1","description":"ICD-FCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Color vision examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92283","description":"Color vision examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33422","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9886","description":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9010","description":"Mccd_ risk adj_ level 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA1","description":"ICD-EALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1002","description":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC0","description":"ICD-NGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD0","description":"ICD-CIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Creatine mb fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82553","description":"Creatine mb fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD1","description":"ICD-KDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF1","description":"ICD-JGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC0","description":"ICD-NELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB1","description":"ICD-JADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sutures diff surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15851","description":"Remove sutures diff surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005U","description":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF0","description":"ICD-GDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular junction test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95937","description":"Neuromuscular junction test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0863T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF1","description":"ICD-CDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271T","description":"Rev/remvl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB0","description":"ICD-CERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC1","description":"ICD-BAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA0","description":"ICD-NEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE1","description":"ICD-PLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC0","description":"ICD-BBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC0","description":"ICD-KGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC0","description":"ICD-OIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","description":"HCPCS-J7299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC PAN-TUM DNA&RNA GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211U","description":"ONC PAN-TUM DNA&RNA GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ occlusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2628","description":"Catheter_ occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurgery penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54056","description":"Cryosurgery penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9044","description":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC0","description":"ICD-HAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC0","description":"ICD-GISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC1","description":"ICD-GGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise vag graft via vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57295","description":"Revise vag graft via vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF0","description":"ICD-OEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA0","description":"ICD-MEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC0","description":"ICD-LCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA1","description":"ICD-IEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF0","description":"ICD-CBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465T","description":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0140","description":"Nonemergency transport air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE0","description":"ICD-CCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE1","description":"ICD-NKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB1","description":"ICD-OKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB05","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5286","description":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD1","description":"ICD-EIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE0","description":"ICD-KCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasma protein fract_5%_50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9043","description":"Plasma protein fract_5%_50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tot contact ak/knee disart s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5650","description":"Tot contact ak/knee disart s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB1","description":"ICD-JAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pegaspargase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9266","description":"Pegaspargase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA0","description":"ICD-OFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE1","description":"ICD-NLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC1","description":"ICD-KEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC1","description":"ICD-CGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mononuclear cell antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86356","description":"Mononuclear cell antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB1","description":"ICD-PHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF0","description":"ICD-ACEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27892","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC0","description":"ICD-CIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Femoral endovas graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34813","description":"Femoral endovas graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC0","description":"ICD-EFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunodiffusion nes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86329","description":"Immunodiffusion nes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF0","description":"ICD-BGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID1","description":"ICD-OAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hf assessment tool completed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3117F","description":"Hf assessment tool completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD1","description":"ICD-GIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69603","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tap block unil by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64486","description":"Tap block unil by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB0","description":"ICD-CBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC1","description":"ICD-EIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF0","description":"ICD-FFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE210","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vessel injection procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36299","description":"Vessel injection procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB0","description":"ICD-KCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1726","description":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB1","description":"ICD-LFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC1","description":"ICD-JFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC1","description":"ICD-FEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult foster care per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5141","description":"Adult foster care per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE0","description":"ICD-PDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD0","description":"ICD-FIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal kidney open complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50225","description":"Removal kidney open complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD0","description":"ICD-KGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA0","description":"ICD-EFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF1","description":"ICD-IDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE0","description":"ICD-EFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8535","description":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9199","description":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB1","description":"ICD-JGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA1","description":"ICD-NEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD230","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF1","description":"ICD-FBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01442","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","description":"CPT-01442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal cortex & medulla img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78075","description":"Adrenal cortex & medulla img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF0","description":"ICD-MABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE0","description":"ICD-EHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No cont ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4186F","description":"No cont ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD0","description":"ICD-GEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA0","description":"ICD-BDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20816","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64629","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC1","description":"ICD-JICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22513","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165T","description":"Revise lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB1","description":"ICD-NABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC1","description":"ICD-GAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib and nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21616","description":"Removal of rib and nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB1","description":"ICD-BDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC0","description":"ICD-BENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test incubate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86921","description":"Compatibility test incubate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA1","description":"ICD-AAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec stains for microorganis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0476","description":"Spec stains for microorganis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB1","description":"ICD-EFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0809T","description":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF1","description":"ICD-OJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB0","description":"ICD-CEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0674","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0674","description":"HCPCS-G0674","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB1","description":"ICD-MDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC23","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF1","description":"ICD-ODRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE0","description":"ICD-BGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF0","description":"ICD-JBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE1","description":"ICD-NEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermavest_ plurivest sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4153","description":"Dermavest_ plurivest sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec site no lung","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9420","description":"Spec site no lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF0","description":"ICD-KEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 300-349mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9962","description":"Hocm 300-349mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA0","description":"ICD-BDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97542","description":"Wheelchair mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE1","description":"ICD-FCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD0","description":"ICD-FBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay growth hormone (hgh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83003","description":"Assay growth hormone (hgh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA1","description":"ICD-GISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sr89 strontium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9600","description":"Sr89 strontium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1046T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1046T","description":"CPT-1046T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21440","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC0","description":"ICD-KGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC1","description":"ICD-GIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ vincristine sul lip 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9371","description":"Inj_ vincristine sul lip 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF0","description":"ICD-GGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA0","description":"ICD-GHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE1","description":"ICD-PHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30420","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE1","description":"ICD-CHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5D","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB0","description":"ICD-GIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tmp manipulation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7820","description":"Closed tmp manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE1","description":"ICD-OBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0C","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA0","description":"ICD-EHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb no presc no reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8698","description":"Antithromb no presc no reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB1","description":"ICD-FIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40810","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99307","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF0","description":"ICD-GATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0491","description":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA0","description":"ICD-AAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE1","description":"ICD-OJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ non-inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2622","description":"Prosthesis_ penile_ non-inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63307","description":"Remov vert idrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB0","description":"ICD-KCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ isavuconazonium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1833","description":"Injection_ isavuconazonium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3355","description":"Pulpal regeneration initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC0","description":"ICD-MDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC1","description":"ICD-BIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0528U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","description":"CPT-0528U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bladder calculi irrig sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2004","description":"Bladder calculi irrig sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF1","description":"ICD-CGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE1","description":"ICD-ODOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC0","description":"ICD-EDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF1","description":"ICD-GHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"20+ cc syringe only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4213","description":"20+ cc syringe only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80438","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA1","description":"ICD-FCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protein analysis w/probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88372","description":"Protein analysis w/probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD0","description":"ICD-HAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE1","description":"ICD-JDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain/barr lk flng/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4427","description":"Ost pch drain/barr lk flng/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98010","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","description":"CPT-98010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC0","description":"ICD-HAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE0","description":"ICD-CILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA0","description":"ICD-BCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Htlv-ii antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86688","description":"Htlv-ii antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9035","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC0","description":"ICD-KCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB0","description":"ICD-KEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF0","description":"ICD-GFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA1","description":"ICD-EDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA1","description":"ICD-CBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6072","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC0","description":"ICD-IAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF1","description":"ICD-BIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA0","description":"ICD-CBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX14","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 20.1-30.0","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12056","description":"Intmd rpr face/mm 20.1-30.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE1","description":"ICD-ODNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:2 to 1:4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1734","description":"Employment - Job Coaching 1:2 to 1:4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99233","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE1","description":"ICD-EGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB0","description":"ICD-NKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_ transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0087U","description":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_ transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA0","description":"ICD-FAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA0","description":"ICD-GDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC1","description":"ICD-FEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid fitting/checking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5011","description":"Hearing aid fitting/checking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC0","description":"ICD-LFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor three anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81510","description":"Ftl cgen abnor three anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF0","description":"ICD-EIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indiv pdc > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9512","description":"Indiv pdc > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-27458","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","description":"CPT-27458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21249","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1504","description":"HCPCS-B1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB0","description":"ICD-OAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA0","description":"ICD-GGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0110","description":"Nonemergency transport bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF0","description":"ICD-PCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC1","description":"ICD-CEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 25-28 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2265","description":"Induced abortion 25-28 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colorec ca scr_ sto bas dna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0464","description":"Colorec ca scr_ sto bas dna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0564T","description":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sternal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1050","description":"Sternal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC1","description":"ICD-OKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB1","description":"ICD-KDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64480","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","description":"HCPCS-J1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA11","description":"ICD-4CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF1","description":"ICD-KCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29035","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8712","description":"Not pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505T","description":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block other peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64450","description":"N block other peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation cheek bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21270","description":"Augmentation cheek bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0677","description":"Non-pneumatic sequential compression garment_ trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE213","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE1","description":"ICD-JGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD0","description":"ICD-IHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF0","description":"ICD-BDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB0","description":"ICD-OLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB0","description":"ICD-HEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC1","description":"ICD-OLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA1","description":"ICD-AGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB35","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28470","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC0","description":"ICD-GACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX52","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","description":"HCPCS-J9011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD1","description":"ICD-MHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL05","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47605","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC154","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genvisc_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9980","description":"Genvisc_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ 1.54-1.65 p/1.60-1.79g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2782","description":"Lens_ 1.54-1.65 p/1.60-1.79g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC1","description":"ICD-LDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF1","description":"ICD-FEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX20","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36576","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99350","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00836","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","description":"CPT-00836","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF1","description":"ICD-NGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD0","description":"ICD-KBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC17","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyclophosphamide oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8530","description":"Cyclophosphamide oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1200","description":"Wheelchair amputee fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC0","description":"ICD-KDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6005","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27146","description":"Incision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4334","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","description":"HCPCS-Q4334","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD0","description":"ICD-JAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED1","description":"ICD-BGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE1","description":"ICD-GHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD1","description":"ICD-MACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intensive outpatient psychia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9480","description":"Intensive outpatient psychia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD1","description":"ICD-OAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electro hearng aid tst both","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92595","description":"Electro hearng aid tst both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25215","description":"Removal of wrist bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE0","description":"ICD-JBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe outflare wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3390","description":"Shoe outflare wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB1","description":"ICD-CBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE0","description":"ICD-KIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE1","description":"ICD-DFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61305","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA1","description":"ICD-BABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9957","description":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF1","description":"ICD-MGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA1","description":"ICD-FBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87182","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","description":"CPT-87182","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9026","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","description":"HCPCS-J9026","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE1","description":"ICD-NIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA1","description":"ICD-MJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD0","description":"ICD-NJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB1","description":"ICD-ABMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50365","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72170","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE1","description":"ICD-ACAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21242","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX17","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB1","description":"ICD-BBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94667","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD0","description":"ICD-GDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE1","description":"ICD-DAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE0","description":"ICD-CGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE0","description":"ICD-DBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB0","description":"ICD-NFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High compres band w>=3in<5inyd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6452","description":"High compres band w>=3in<5inyd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB0","description":"ICD-ODDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0304","description":"HCPCS-B0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC0","description":"ICD-PDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB1","description":"ICD-KCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF1","description":"ICD-CDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening propoxyphene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80367","description":"Drug screening propoxyphene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92993","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77074","description":"X-rays bone survey limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95117","description":"Immunotherapy injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60600","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Security Deposit)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7334","description":"Community Transition Svcs (Security Deposit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA0","description":"ICD-JEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36905","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA1","description":"ICD-EABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA0","description":"ICD-CHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB260","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78432","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52214","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE1","description":"ICD-LFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB0","description":"ICD-GBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF0","description":"ICD-GFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA1","description":"ICD-MBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0639","description":"Lso s/c shell/panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF1","description":"ICD-KHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF0","description":"ICD-GIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc fx & test/txmnt for op","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5015F","description":"Doc fx & test/txmnt for op","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA20","description":"Default_ /14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6116","description":"Imp/abut fixed dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC1","description":"ICD-JEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydromorphone 250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0092","description":"Hydromorphone 250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA12","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behav chng smoking > 10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99407","description":"Behav chng smoking > 10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0603","description":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10120","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE0","description":"ICD-FCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC1","description":"ICD-BCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5A","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39000","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","description":"HCPCS-M1399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE0","description":"ICD-JCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD0","description":"ICD-FCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD1","description":"ICD-JFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD0","description":"ICD-OILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC1","description":"ICD-NCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE0","description":"ICD-ECBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE1","description":"ICD-FGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC25","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple sleep latency test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95805","description":"Multiple sleep latency test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj aripiprazole ext rel 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0401","description":"Inj aripiprazole ext rel 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB1","description":"ICD-BGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD1","description":"ICD-KILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat ht <17 or >=21 ltwt wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0056","description":"Seat ht <17 or >=21 ltwt wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF1","description":"ICD-PBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF0","description":"ICD-OKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF0","description":"ICD-FIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC1","description":"ICD-CHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD0","description":"ICD-GFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC1","description":"ICD-NEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxytetracycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2460","description":"Oxytetracycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion total face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15780","description":"Dermabrasion total face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED1","description":"ICD-KEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC1","description":"ICD-CDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE1","description":"ICD-CGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33406","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","description":"HCPCS-M1433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA1","description":"ICD-OLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","description":"HCPCS-M1382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC1","description":"ICD-NCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF1","description":"ICD-JAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC06","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF0","description":"ICD-IBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Igh gene rearrange amp meth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81261","description":"Igh gene rearrange amp meth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA0","description":"ICD-KEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF1","description":"ICD-NIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited motion knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2184","description":"Limited motion knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE1","description":"ICD-JBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC1","description":"ICD-CAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE1","description":"ICD-MEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat each add spine fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22328","description":"Treat each add spine fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"XWRAP_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4204","description":"XWRAP_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33863","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52648","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD0","description":"ICD-HHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1804","description":"CDT-D1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96934","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9313","description":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gemtuzumab ozogamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9300","description":"Gemtuzumab ozogamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28110","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF0","description":"ICD-AHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC1","description":"ICD-JFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD0","description":"ICD-CFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF1","description":"ICD-NHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF1","description":"ICD-OHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC0","description":"ICD-BATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF0","description":"ICD-CDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant tiagabine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80199","description":"Drug screen quant tiagabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD1","description":"ICD-NLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92060","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE1","description":"ICD-LISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA1","description":"ICD-FBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD0","description":"ICD-GGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory setting substance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9475","description":"Ambulatory setting substance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation >88%/pao>55 hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3037F","description":"O2 saturation >88%/pao>55 hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66920","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50970","description":"Ureter endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67800","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt dischg <=2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9255","description":"Doc pt dischg <=2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27698","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC30","description":"Very High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC1","description":"ICD-AETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA0","description":"ICD-DGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC0","description":"ICD-OIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 pc ost pouch w filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5056","description":"1 pc ost pouch w filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biological materials","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3431","description":"Biological materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD1","description":"ICD-CHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tourniquet for dialysis_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4929","description":"Tourniquet for dialysis_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA1","description":"ICD-LIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB1","description":"ICD-JAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB1","description":"ICD-NGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB0","description":"ICD-AIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fev >/=40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3042F","description":"Fev >/=40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE1","description":"ICD-KDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB0","description":"ICD-HBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infliximab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80230","description":"Infliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93650","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF1","description":"ICD-KHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69610","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tiss exam molecular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88387","description":"Tiss exam molecular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng provided symp mngmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4350F","description":"Cnslng provided symp mngmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77062","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB1","description":"ICD-NDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB1","description":"ICD-FCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC1","description":"ICD-GGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB1","description":"ICD-ECTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB0","description":"ICD-JAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1063T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1063T","description":"CPT-1063T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33953","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply long leg cast brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29358","description":"Apply long leg cast brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25120","description":"Removal of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC0","description":"ICD-OEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99607","description":"Mtms by pharm addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inner skull vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61702","description":"Inner skull vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD0","description":"ICD-NCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1064T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1064T","description":"CPT-1064T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169U","description":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC0","description":"ICD-JDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD0","description":"ICD-NCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD1","description":"ICD-CITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knee 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73562","description":"X-ray exam of knee 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prostate biopsy_ any mthd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0416","description":"Prostate biopsy_ any mthd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4A","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC1","description":"ICD-OHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD1","description":"ICD-KAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC0","description":"ICD-MJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face les sbq 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21012","description":"Exc face les sbq 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME0","description":"ICD-EDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29125","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF0","description":"ICD-PERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC0","description":"ICD-NHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE211","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trastuzumab administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9835","description":"Trastuzumab administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF0","description":"ICD-BIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE1","description":"ICD-IDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remis 6m w/o 6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9574","description":"Remis 6m w/o 6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF0","description":"ICD-CISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE0","description":"ICD-MBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF0","description":"ICD-KCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC1","description":"ICD-IEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA0","description":"ICD-PEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental saliography","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0310","description":"Dental saliography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA236","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trichomonas vagin dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87660","description":"Trichomonas vagin dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93015","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD0","description":"ICD-MGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD0","description":"ICD-EFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC1","description":"ICD-FGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Improving care for lower extremity joint repair mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0058","description":"Improving care for lower extremity joint repair mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB1","description":"ICD-GIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Baclofen intrathecal trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0476","description":"Baclofen intrathecal trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34051","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF0","description":"ICD-JGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB0","description":"ICD-OHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC0","description":"ICD-GHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29820","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lumb artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22865","description":"Remove lumb artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33989","description":"Removal of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26370","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD0","description":"ICD-GHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB1","description":"ICD-FIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80504","description":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX17","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505F","description":"Hemodialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20938","description":"Sp bone agrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2101","description":"HCPCS-B2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA0","description":"ICD-BDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC0","description":"ICD-GCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC0","description":"ICD-GDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE0","description":"ICD-KBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD0","description":"ICD-OGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA1","description":"ICD-GFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED0","description":"ICD-BGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD1","description":"ICD-NJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand les sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26115","description":"Exc hand les sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC1","description":"ICD-KFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC1","description":"ICD-KHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB1","description":"ICD-HISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC0","description":"ICD-PESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF0","description":"ICD-ODVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit corticosteroid/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9490","description":"Hit corticosteroid/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB0","description":"ICD-EGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthoped ladies shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3216","description":"Orthoped ladies shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE114","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA1","description":"ICD-MDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4297","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","description":"HCPCS-A4297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE0","description":"ICD-CCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp<5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99148","description":"Mod sed diff phys/qhp<5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19294","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0524","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA0","description":"ICD-OEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0842T","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nikaidoh proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33782","description":"Nikaidoh proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parathyroid planar imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78070","description":"Parathyroid planar imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB1","description":"ICD-PHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA1","description":"ICD-FHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD0","description":"ICD-FECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE1","description":"ICD-CHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD0","description":"ICD-MJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infusion pump sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0791","description":"Parenteral infusion pump sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22860","description":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","description":"HCPCS-A6548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE0","description":"ICD-DIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx l/r atrial fib addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93657","description":"Tx l/r atrial fib addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF0","description":"ICD-KFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF0","description":"ICD-NHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC0","description":"ICD-KAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15772","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalists Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4009","description":"Hospitalists Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1A","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC0","description":"ICD-CCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36581","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA21","description":"ICD-4LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt trnsfrd from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581F","description":"Pt trnsfrd from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67882","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE1","description":"ICD-CFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1130","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD0","description":"ICD-ACDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9245","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9245","description":"CDT-D9245","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD0","description":"ICD-IHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary hvy plstc pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4382","description":"Urinary hvy plstc pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE1","description":"ICD-GBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC0","description":"ICD-JIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF1","description":"ICD-GDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4343","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","description":"HCPCS-Q4343","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD0","description":"ICD-ODHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF1","description":"ICD-GILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA1","description":"ICD-GGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9336","description":"Hit cont anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF0","description":"ICD-GGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD0","description":"ICD-CACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF1","description":"ICD-CGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","description":"HCPCS-A2033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25650","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anastrozole 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0170","description":"Anastrozole 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD0","description":"ICD-FIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2151","description":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC1","description":"ICD-CGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF0","description":"ICD-NLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF0","description":"ICD-CAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45331","description":"Sigmoidoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB0","description":"ICD-KAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA1","description":"ICD-NFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD0","description":"ICD-GIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC1","description":"ICD-KBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE111","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE0","description":"ICD-KIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA0","description":"ICD-BDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE0","description":"ICD-MHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76870","description":"Us exam scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF1","description":"ICD-GEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50576","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB1","description":"ICD-JAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC0","description":"ICD-CFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD1","description":"ICD-CFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE0","description":"ICD-GAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME0","description":"ICD-EAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5100","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","description":"HCPCS-Q5100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9284","description":"No hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35558","description":"Art byp grft fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD1","description":"ICD-JCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB0","description":"ICD-PHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","description":"CPT-55715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1094T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1094T","description":"CPT-1094T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA1","description":"ICD-JFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt alkaline 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0603","description":"Repl batt alkaline 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF1","description":"ICD-DGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB0","description":"ICD-CBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA1","description":"ICD-CIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF0","description":"ICD-PAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE0","description":"ICD-ODXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB0","description":"ICD-GDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB1","description":"ICD-BDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF0","description":"ICD-OCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1145","description":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl stg unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9138","description":"Onc dx nhl stg unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plating chrome/nickel pr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2750","description":"Plating chrome/nickel pr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"User adjustable heel height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5990","description":"User adjustable heel height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA0","description":"ICD-NDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC1","description":"ICD-GCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA1","description":"ICD-KGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE0","description":"ICD-OAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1174","description":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE1","description":"ICD-FHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF0","description":"ICD-EGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE1","description":"ICD-MKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE126","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2D","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp grade elec breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0604","description":"Hosp grade elec breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB1","description":"ICD-NAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62282","description":"Treat spinal canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic subs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2740","description":"Crown porcelain/ceramic subs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD1","description":"ICD-NLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE0","description":"ICD-FHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF0","description":"ICD-OGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE1","description":"ICD-OEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cur funct asses; no care pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8543","description":"Cur funct asses; no care pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA0","description":"ICD-BCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF0","description":"ICD-OISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy/dynamometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92260","description":"Ophthalmoscopy/dynamometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63182","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD0","description":"ICD-IGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB0","description":"ICD-DIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE0","description":"ICD-BGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88377","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND0","description":"ICD-JIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD0","description":"ICD-OJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE0","description":"ICD-MKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE0","description":"ICD-JGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Donor pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32850","description":"Donor pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB0","description":"ICD-MBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC0","description":"ICD-NKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/o sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2631","description":"Rep dev_ urinary_ w/o sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ PTEN hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101U","description":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ PTEN hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF1","description":"ICD-DIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF0","description":"ICD-MGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0C","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF0","description":"ICD-MKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD1","description":"ICD-FHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0582","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","description":"HCPCS-J0582","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA1","description":"ICD-LGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33542","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX34","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0856","description":"Pwc gp3 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand/chin ctrl std joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2374","description":"Hand/chin ctrl std joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5212","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB0","description":"ICD-MABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0650","description":"Lso sc r ant/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn no scr etoh use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9623","description":"Doc med rsn no scr etoh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer tendon to pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27098","description":"Transfer tendon to pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78709","description":"K flow/funct image multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267U","description":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Position back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2614","description":"Position back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB1","description":"ICD-OHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0620","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD0","description":"ICD-KAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0315","description":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8688","description":"Implt nrostm pls gen dua non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC42","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC1","description":"ICD-FCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA1","description":"ICD-KIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interdiscal perq aspir dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62267","description":"Interdiscal perq aspir dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB0","description":"ICD-FFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE1","description":"ICD-OCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF0","description":"ICD-AGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA1","description":"ICD-BFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE1","description":"ICD-OKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92019","description":"Eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin intermed 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5552","description":"Insulin intermed 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB1","description":"ICD-CAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC0","description":"ICD-DEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC1","description":"ICD-KHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1499","description":"Spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB0","description":"ICD-MBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA1","description":"ICD-CFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","description":"CPT-00626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC0","description":"ICD-GIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1250","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0677U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677U","description":"CPT-0677U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE1","description":"ICD-ICIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE1","description":"ICD-BHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axill-fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35654","description":"Art byp axill-fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE0","description":"ICD-JFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC0","description":"ICD-MFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE0","description":"ICD-OFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0805T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD1","description":"ICD-NHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24650","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE113","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53510","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA0","description":"ICD-IEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2999","description":"Lower extremity orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC1","description":"ICD-GEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE1","description":"ICD-NLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB1","description":"ICD-GCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0295","description":"Hosp bed semi-elect w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2B","description":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15945","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF0","description":"ICD-CIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB0","description":"ICD-OHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED0","description":"ICD-BAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2642","description":"Dental onlay porcelin 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC1","description":"ICD-OFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27405","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX06","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81211","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA0","description":"ICD-GIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thigh length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4495","description":"Thigh length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF1","description":"ICD-KAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE1","description":"ICD-FGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove kidney living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50320","description":"Remove kidney living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck t3-4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9110","description":"Onc dx head/neck t3-4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subtemporal decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61340","description":"Subtemporal decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC0","description":"ICD-ICUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC1","description":"ICD-BFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BioNextPATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4228","description":"BioNextPATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78258","description":"Esophageal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ imm glob bivigam_ 500mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1556","description":"Inj_ imm glob bivigam_ 500mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE0","description":"ICD-OBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF0","description":"ICD-OLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL55","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21082","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laetrile amygdalin vit b17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3570","description":"Laetrile amygdalin vit b17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenylephrine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2370","description":"Phenylephrine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx planar_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2645","description":"Brachytx planar_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coronectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7251","description":"Coronectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc esrd dia trans preg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9231","description":"Doc esrd dia trans preg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB0","description":"ICD-JFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","description":"HCPCS-M1428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE1","description":"ICD-BCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27792","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9328","description":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE1","description":"ICD-FHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6081","description":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq revasc byp graft 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92937","description":"Prq revasc byp graft 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Who w/nontorsion jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3905","description":"Who w/nontorsion jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1243","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE0","description":"ICD-FGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD0","description":"ICD-OBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0104","description":"HCPCS-B0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0006","description":"Heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF0","description":"ICD-JDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE0","description":"ICD-JFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7604","description":"Acetylcysteine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD0","description":"ICD-AITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press headgear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7035","description":"Pos airway press headgear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE1","description":"ICD-NFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB251","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNE0","description":"ICD-NLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","description":"HCPCS-M1375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serial tonometry exam(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92100","description":"Serial tonometry exam(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA0","description":"ICD-OJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11463","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF0","description":"ICD-PKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE0","description":"ICD-FBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB0","description":"ICD-KAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63085","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA0","description":"ICD-KBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA1","description":"ICD-ODRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC1","description":"ICD-OFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE0","description":"ICD-HGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC0","description":"ICD-CGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD134","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0733T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rec antivir treat hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8461","description":"Pt rec antivir treat hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"12-lead ecg performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3120F","description":"12-lead ecg performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC0","description":"ICD-HDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA1","description":"ICD-FDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9787","description":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC0","description":"ICD-JHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA0","description":"ICD-EIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB1","description":"ICD-GEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF1","description":"ICD-EFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD1","description":"ICD-JIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg > 40 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2506","description":"Sgd prerec msg > 40 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA1","description":"ICD-GBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude organ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37243","description":"Vasc embolize/occlude organ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA0","description":"ICD-KDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision/drain abscess intra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7511","description":"Incision/drain abscess intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA0","description":"ICD-NCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD0","description":"ICD-KCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore orbit/remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61333","description":"Explore orbit/remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompressive lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61323","description":"Decompressive lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA1","description":"ICD-OCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5410","description":"Dentures adjust cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF0","description":"ICD-LDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF1","description":"ICD-GIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID1","description":"ICD-OCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE1","description":"ICD-KHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48000","description":"Drainage of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0091","description":"Granisetron 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF0","description":"ICD-EFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73115","description":"Contrast x-ray of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria toxoid_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90719","description":"Diphtheria toxoid_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC0","description":"ICD-MCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA0","description":"ICD-OCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF1","description":"ICD-IHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ spesolimab-sbzo_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1747","description":"Injection_ spesolimab-sbzo_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA1","description":"ICD-FCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on salivary glands_ including biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113U","description":"Anesthesia for procedures on salivary glands_ including biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA1","description":"ICD-EGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB1","description":"ICD-GANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC1","description":"ICD-PGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF1","description":"ICD-KHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB0","description":"ICD-MHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No qual card diag prior12mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1461F","description":"No qual card diag prior12mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID1","description":"ICD-GCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stnd wt pwr whlchr w control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0011","description":"Stnd wt pwr whlchr w control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg pulmon sequest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2403","description":"Fetal surg pulmon sequest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5521","description":"Hit midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB1","description":"ICD-GGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB0","description":"ICD-NHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD0","description":"ICD-EELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9076","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA1","description":"ICD-LBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1188","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE0","description":"ICD-MKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD0","description":"ICD-AETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF1","description":"ICD-IIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genotype cytomegalovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87910","description":"Genotype cytomegalovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","description":"HCPCS-J8541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-asst vag hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58550","description":"Laparo-asst vag hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","description":"HCPCS-M1379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA0","description":"ICD-ODOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME0","description":"ICD-BEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","description":"HCPCS-J9342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE1","description":"ICD-CCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC43","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Renal biopsy perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50200","description":"Renal biopsy perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF1","description":"ICD-ICBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol valerate 10 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1380","description":"Estradiol valerate 10 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD116","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF0","description":"ICD-FFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC0","description":"ICD-LBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE1","description":"ICD-OFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0581U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","description":"CPT-0581U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24500","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis delta agent antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86692","description":"Hepatitis delta agent antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ breast_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1789","description":"Prosthesis_ breast_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl trans to lg bcell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9136","description":"Onc dx nhl trans to lg bcell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF1","description":"ICD-ABBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF0","description":"ICD-EHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE1","description":"ICD-FIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC1","description":"ICD-NFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF1","description":"ICD-HESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB1","description":"ICD-FGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB1","description":"ICD-BBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF1","description":"ICD-BGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC1","description":"ICD-MLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA1","description":"ICD-NAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/ stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21320","description":"Closed tx nose fx w/ stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45020","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23620","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE1","description":"ICD-GEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE1","description":"ICD-JIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA0","description":"ICD-IEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pres/absn urine incon assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1090F","description":"Pres/absn urine incon assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD1","description":"ICD-NEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB0","description":"ICD-OGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC1","description":"ICD-KICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF1","description":"ICD-JGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00950","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","description":"CPT-00950","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5941","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5941","description":"CDT-D5941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC0","description":"ICD-OBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE1","description":"ICD-MAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3D printing of a 3D dental surfacet scan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0396","description":"3D printing of a 3D dental surfacet scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA1","description":"ICD-EIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4354","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","description":"HCPCS-Q4354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Review/report bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93790","description":"Review/report bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45150","description":"Excision of rectal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE1","description":"ICD-KGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98966","description":"Hc pro phone call 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9312","description":"Surgical site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC0","description":"ICD-IIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"One-way allow prorated miles","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9603","description":"One-way allow prorated miles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB1","description":"ICD-GDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0039U","description":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Droperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1790","description":"Droperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB0","description":"ICD-JGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Salivary gland imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78230","description":"Salivary gland imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF1","description":"ICD-GBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD1","description":"ICD-MJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81343","description":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy abdom method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58140","description":"Myomectomy abdom method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt lithium 4.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0605","description":"Repl batt lithium 4.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD1","description":"ICD-OBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Int therapeutic restoration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2941","description":"Int therapeutic restoration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB0","description":"ICD-JIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD0","description":"ICD-KFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED0","description":"ICD-MKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0239U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB1","description":"ICD-JHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB45","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cholera vaccine for injectable use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90725","description":"Cholera vaccine for injectable use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex for nonspeech dev rx add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92618","description":"Ex for nonspeech dev rx add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular stim for scoli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0744","description":"Neuromuscular stim for scoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE0","description":"ICD-NHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blm gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81209","description":"Blm gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53010","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No eval activity clin symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3119F","description":"No eval activity clin symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE0","description":"ICD-OAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0703","description":"HCPCS-B0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath indw foley 2 way silicn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4344","description":"Cath indw foley 2 way silicn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD0","description":"ICD-KHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27848","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB0","description":"ICD-JDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Renal biopsy open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50205","description":"Renal biopsy open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF0","description":"ICD-HESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reclining back add ped w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1014","description":"Reclining back add ped w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 8 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP08","description":"Auto.test pane pricing code_ 8 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Accession of brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0486","description":"Accession of brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg all night recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95827","description":"Eeg all night recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA0","description":"ICD-NAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE0","description":"ICD-KGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE1","description":"ICD-GCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC1","description":"ICD-FAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC1","description":"ICD-JEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102T","description":"Extracorp shockwv tx anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF0","description":"ICD-KALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC112","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD0","description":"ICD-EHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0D","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB0","description":"ICD-GBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29897","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF0","description":"ICD-GIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA1","description":"ICD-OEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC0","description":"ICD-GHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD1","description":"ICD-FBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc spermatic cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55559","description":"Laparo proc spermatic cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dalteparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1645","description":"Dalteparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD0","description":"ICD-BILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdom complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76700","description":"Us exam abdom complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA0","description":"ICD-MLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0578U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","description":"CPT-0578U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC0","description":"ICD-KFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE1","description":"ICD-ACCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4171F","description":"Pt rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6714","description":"Ped term dev_ hand_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op asst doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9615","description":"Pre-op asst doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB1","description":"ICD-FELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF0","description":"ICD-GAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whchr s-recl fxd arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1100","description":"Whchr s-recl fxd arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA1","description":"ICD-KHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND1","description":"ICD-OBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF1","description":"ICD-FGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA1","description":"ICD-FEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2108","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD1","description":"ICD-MGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF1","description":"ICD-LGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286U","description":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA1","description":"ICD-FEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90476","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11426","description":"Exc h-f-nk-sp b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD1","description":"ICD-DHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64822","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30630","description":"Repair nasal septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA1","description":"ICD-CDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC1","description":"ICD-HASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC0","description":"ICD-IHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL16","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29844","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID1","description":"ICD-NBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF1","description":"ICD-BEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosth retina receive&gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100T","description":"Prosth retina receive&gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF0","description":"ICD-KDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intentional replantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3470","description":"Intentional replantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA0","description":"ICD-IEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC0","description":"ICD-DAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2091","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96573","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA0","description":"ICD-KFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC0","description":"ICD-EEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB0","description":"ICD-JHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64901","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD0","description":"ICD-OGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8421","description":"Ready gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37298","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","description":"CPT-37298","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB1","description":"ICD-ABBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rev_ comm_ track_ doc biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8883","description":"Rev_ comm_ track_ doc biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6251","description":"Bridge resin base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF0","description":"ICD-OICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA0","description":"ICD-FDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD1","description":"ICD-NDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF1","description":"ICD-CGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE1","description":"ICD-EFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF0","description":"ICD-OBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC260","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC1","description":"ICD-CAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE0","description":"ICD-GFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF1","description":"ICD-DBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thiocyanate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84430","description":"Assay of thiocyanate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt tk tams hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9503","description":"Pt tk tams hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD1","description":"ICD-BEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC1","description":"ICD-OCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE1","description":"ICD-FEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2203","description":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE1","description":"ICD-BGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meropenem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2185","description":"Meropenem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0323","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD1","description":"ICD-NEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20520","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2197","description":"Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF0","description":"ICD-DBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repr per/vag pouch sngl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46710","description":"Repr per/vag pouch sngl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin depression screen not d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8432","description":"Clin depression screen not d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lwr ext dynamic prosth pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5985","description":"Lwr ext dynamic prosth pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD1","description":"ICD-NHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr special size/constrc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1220","description":"Whlchr special size/constrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF0","description":"ICD-OJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular denture prosth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5935","description":"Mandibular denture prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE0","description":"ICD-BAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE1","description":"ICD-AHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sclerotx fluid collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49185","description":"Sclerotx fluid collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37265","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","description":"CPT-37265","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb not doc rns not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8974","description":"Hgb not doc rns not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC1","description":"ICD-MJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Single pivot hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6605","description":"Single pivot hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1092T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1092T","description":"CPT-1092T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2520","description":"Th/wght bear quad-lat brim c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF0","description":"ICD-CHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43351","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC0","description":"ICD-ABIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2092","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interscap-thor myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6975","description":"Interscap-thor myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95979","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Voice goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9172","description":"Voice goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2389","description":"Foam caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB1","description":"ICD-MBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF0","description":"ICD-CGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE1","description":"ICD-OGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36569","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA0","description":"ICD-DFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of femur epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27185","description":"Revision of femur epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE0","description":"ICD-KBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE1","description":"ICD-LASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE0","description":"ICD-KFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE1","description":"ICD-NHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50740","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF1","description":"ICD-AHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for needle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77012","description":"Ct scan for needle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD1","description":"ICD-GCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE1","description":"ICD-GGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0553","description":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE1","description":"ICD-PFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA0","description":"ICD-JEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","description":"HCPCS-J9003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE0","description":"ICD-GEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> mus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64644","description":"Chemodenerv 1 extrem 5/> mus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual cell count each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85032","description":"Manual cell count each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26715","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9712","description":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC1","description":"ICD-ICCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA0","description":"ICD-CCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF0","description":"ICD-OEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4033","description":"Cast sup lng leg cylinder pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31290","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC1","description":"ICD-MECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84153","description":"Assay of psa total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3A","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC0","description":"ICD-MLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA1","description":"ICD-KCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1104T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1104T","description":"CPT-1104T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC0","description":"ICD-OGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF0","description":"ICD-NBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF0","description":"ICD-JAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD0","description":"ICD-FAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23430","description":"Repair biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0501U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","description":"CPT-0501U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC1","description":"ICD-GBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA0","description":"ICD-CBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FY GNOTYP ACKR1 EXONS 1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0187U","description":"FY GNOTYP ACKR1 EXONS 1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC0","description":"ICD-NGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rigid ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1235","description":"Rigid ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD0","description":"ICD-NDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC0","description":"ICD-BDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA1","description":"ICD-OAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC0","description":"ICD-PGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE1","description":"ICD-OJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42107","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99394","description":"Prev visit est age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopha dx beta amyloid pet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9599","description":"Radiopha dx beta amyloid pet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63199","description":"Incise spin&cord 2 stgs thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1714","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC1","description":"ICD-OGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0136","description":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69220","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81441","description":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0C","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA1","description":"ICD-KFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE0","description":"ICD-CEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF0","description":"ICD-OEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE0","description":"ICD-CBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC0","description":"ICD-FCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC215","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB0","description":"ICD-IBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD0","description":"ICD-GCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE0","description":"ICD-BHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA1","description":"ICD-MLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD0","description":"ICD-IELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1002","description":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA1","description":"ICD-OCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1803","description":"HCPCS-A1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD1","description":"ICD-PJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384T","description":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD1","description":"ICD-KBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29805","description":"Shoulder arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF0","description":"ICD-BDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB11","description":"ICD-2HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28605","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB0","description":"ICD-EAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB0","description":"ICD-MKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF0","description":"ICD-NCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD0","description":"ICD-ODRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analgesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9230","description":"Analgesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD1","description":"ICD-FHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9407","description":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML03","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB0","description":"ICD-GHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE0","description":"ICD-FITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percussor elect/pneum home m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0480","description":"Percussor elect/pneum home m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE1","description":"ICD-OIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF1","description":"ICD-BAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10B","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB1","description":"ICD-NBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA1","description":"ICD-BDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB0","description":"ICD-MIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC0","description":"ICD-NEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA0","description":"ICD-FDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID0","description":"ICD-IGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC1","description":"ICD-AGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF0","description":"ICD-KENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB1","description":"ICD-OGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD1","description":"ICD-CDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal therapy anterior prim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3230","description":"Pulpal therapy anterior prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF0","description":"ICD-OGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36011","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA0","description":"ICD-FAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF0","description":"ICD-DAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC1","description":"ICD-JFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31573","description":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD250","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD0","description":"ICD-MBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dihydromorphinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6046","description":"Dihydromorphinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF0","description":"ICD-OGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD1","description":"ICD-GAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace/revise brain shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62230","description":"Replace/revise brain shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD0","description":"ICD-BEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pelvis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84451","description":"Anesth pelvis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0017","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of cervix radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57531","description":"Removal of cervix radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8522","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","description":"HCPCS-J8522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4064F","description":"Antidepressant rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED0","description":"ICD-JCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB0","description":"ICD-BGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frame depth 22 to 25 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2204","description":"Frame depth 22 to 25 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA1","description":"ICD-CERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (House Hold Suppl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7332","description":"Community Transition Svcs (House Hold Suppl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF0","description":"ICD-MDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24342","description":"Repair of ruptured tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF0","description":"ICD-IETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient with diagnosis of osteoporosis on date of encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1153","description":"Patient with diagnosis of osteoporosis on date of encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD1","description":"ICD-JCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene other bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81208","description":"Bcr/abl1 gene other bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC0","description":"ICD-NIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC1","description":"ICD-HHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","description":"HCPCS-Q5154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE0","description":"ICD-HHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asser com tx face-face/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0039","description":"Asser com tx face-face/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2252","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","description":"HCPCS-J2252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-82234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","description":"CPT-82234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preputial stretching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54450","description":"Preputial stretching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC0","description":"ICD-BBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29838","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/o lck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6695","description":"Elbow socket ins use w/o lck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE1","description":"ICD-MDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unipuncture control system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1580","description":"Unipuncture control system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5119","description":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD1","description":"ICD-OCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE0","description":"ICD-OIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD0","description":"ICD-OELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA0","description":"ICD-GCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dressing change not for burn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15852","description":"Dressing change not for burn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5D","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE1","description":"ICD-DDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF0","description":"ICD-HHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA1","description":"ICD-GDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA0","description":"ICD-GEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA0","description":"ICD-EBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB0","description":"ICD-FCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26605","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rsa spine exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348T","description":"Rsa spine exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","description":"CPT-00930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA0","description":"ICD-IFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF1","description":"ICD-MKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99375","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE0","description":"ICD-PGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF0","description":"ICD-CHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/over 6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2110","description":"Spherocylinder 4.25d/over 6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD0","description":"ICD-CGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD1","description":"ICD-OKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB1","description":"ICD-JABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gtt-added samples","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82952","description":"Gtt-added samples","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF0","description":"ICD-NHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD0","description":"ICD-CHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE0","description":"ICD-OHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD1","description":"ICD-GEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA1","description":"ICD-AGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB0","description":"ICD-DDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE1","description":"ICD-FBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0534U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","description":"CPT-0534U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88027","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF1","description":"ICD-CFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC1","description":"ICD-IEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE1","description":"ICD-MKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA0","description":"ICD-NAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC0","description":"ICD-GEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cavopulmonary shunting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33768","description":"Cavopulmonary shunting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC1","description":"ICD-KCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC1","description":"ICD-OKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF1","description":"ICD-DIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC1","description":"ICD-FHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA0","description":"ICD-GBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC0","description":"ICD-MDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82077","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD0","description":"ICD-KCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA1","description":"ICD-FEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate subq defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93261","description":"Interrogate subq defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB1","description":"ICD-ICMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 5.1-10cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11952","description":"Tx contour defects 5.1-10cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD140","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft trunk add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15201","description":"Skin full graft trunk add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC1","description":"ICD-BHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD0","description":"ICD-BHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA0","description":"ICD-GATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4184","description":"Cellesta_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE231","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33802","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB1","description":"ICD-JANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66840","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD0","description":"ICD-MCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable liquid oxygen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0433","description":"Portable liquid oxygen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA1","description":"ICD-NCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF0","description":"ICD-EADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB1","description":"ICD-FATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC1","description":"ICD-JDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE0","description":"ICD-JFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA0","description":"ICD-EDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509T","description":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services outside us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9989","description":"Services outside us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD0","description":"ICD-NHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF0","description":"ICD-FGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27303","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor ix ptc/chrstmas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85250","description":"Clot factor ix ptc/chrstmas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6001","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC146","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF0","description":"ICD-FIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81426","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB1","description":"ICD-BIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC0","description":"ICD-GDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA0","description":"ICD-BECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9130","description":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/long tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34805","description":"Endovas aaa repr w/long tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain w/ h noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2750","description":"Crown porcelain w/ h noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID1","description":"ICD-KIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA136","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15935","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Hpc Nos 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9985","description":"Injection Hpc Nos 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD0","description":"ICD-KDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth testis exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92451","description":"Anesth testis exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4105","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8F","description":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic cont infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64463","description":"Pvb thoracic cont infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF0","description":"ICD-NEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF0","description":"ICD-MLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD0","description":"ICD-OLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF0","description":"ICD-NINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4276","description":"Orion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2662","description":"Dental onlay resin 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81344","description":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2024","description":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE1","description":"ICD-GGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 30MCG/0.3 ML BST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004A","description":"ADM SARSCOV2 30MCG/0.3 ML BST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC1","description":"ICD-EBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27087","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC0","description":"ICD-GIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab Intravenous Inj 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9989","description":"Ustekinumab Intravenous Inj 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain bladder by trocar/cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51101","description":"Drain bladder by trocar/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94690","description":"Exhaled air analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0866T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB05","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject pulm art hrt cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93568","description":"Inject pulm art hrt cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","description":"HCPCS-J1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet img wholbod melano nonco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0219","description":"Pet img wholbod melano nonco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA1","description":"ICD-GBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD0","description":"ICD-OAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64658","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","description":"CPT-64658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF0","description":"ICD-CHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC0","description":"ICD-BFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB1","description":"ICD-OIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE1","description":"ICD-HHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD1","description":"ICD-ODRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35355","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC1","description":"ICD-CBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL01","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF1","description":"ICD-FINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD1","description":"ICD-CBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76979","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC0","description":"ICD-OBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25520","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA0","description":"ICD-DIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC1","description":"ICD-NLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD0","description":"ICD-NIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special teletx port plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77321","description":"Special teletx port plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX44","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63101","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0859","description":"Pwc gp3 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of homocystine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83090","description":"Assay of homocystine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1903","description":"HCPCS-C1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF1","description":"ICD-MKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy upr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15878","description":"Suction lipectomy upr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD0","description":"ICD-HGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Over-bed table","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0274","description":"Over-bed table","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA1","description":"ICD-MILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gene test myo musclr dyst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3853","description":"Gene test myo musclr dyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA0","description":"ICD-BIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE0","description":"ICD-OGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/3+ post-op nausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4556F","description":"Pt w/3+ post-op nausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE1","description":"ICD-IBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE106","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB1","description":"ICD-GDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4004","description":"Cast sup shoulder cast fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA0","description":"ICD-BFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27485","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD1","description":"ICD-ECCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0497T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209T","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE1","description":"ICD-EBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB1","description":"ICD-CDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE0","description":"ICD-PIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15241","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97018","description":"Paraffin bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB1","description":"ICD-JDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF0","description":"ICD-DGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rep perf anoper fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46715","description":"Rep perf anoper fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD1","description":"ICD-BAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93642","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC1","description":"ICD-FGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motion fluoroscopy/swallow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92611","description":"Motion fluoroscopy/swallow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt support & positioning sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0636","description":"Pt support & positioning sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC1","description":"ICD-MGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA0","description":"ICD-KAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA0","description":"ICD-OHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJND1","description":"ICD-NJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD0","description":"ICD-KCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64580","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33464","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC0","description":"ICD-GFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412U","description":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99174","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE1","description":"ICD-OEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA0","description":"ICD-JHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7519","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB12","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF0","description":"ICD-FAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home episodic case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0272","description":"Home episodic case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methocarbamol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2800","description":"Methocarbamol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42160","description":"Treatment mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE0","description":"ICD-IGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex for speech device rx 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92607","description":"Ex for speech device rx 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27517","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC1","description":"ICD-BIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178T","description":"64 lead ecg w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF1","description":"ICD-FEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer reservoir bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7009","description":"Nebulizer reservoir bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC1","description":"ICD-HERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29807","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bicarbonate conc pow per pac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4707","description":"Bicarbonate conc pow per pac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF0","description":"ICD-PGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hyoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21495","description":"Treat hyoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical place mini implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6013","description":"Surgical place mini implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB1","description":"ICD-FHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD0","description":"ICD-CHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9786","description":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB0","description":"ICD-GDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78815","description":"Pet image w/ct skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC0","description":"ICD-KBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD0","description":"ICD-CHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF0","description":"ICD-KEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC0","description":"ICD-GHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF1","description":"ICD-NLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF1","description":"ICD-NDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC1","description":"ICD-OCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22112","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80342","description":"Antipsychotics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC1","description":"ICD-JBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF0","description":"ICD-ABUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27385","description":"Repair of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intracav admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79200","description":"Nuclear rx intracav admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC0","description":"ICD-MAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49606","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01112","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","description":"CPT-01112","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forensic cytopathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88125","description":"Forensic cytopathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy roof of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42100","description":"Biopsy roof of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB1","description":"ICD-OCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32659","description":"Thoracoscopy w/sac drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC1","description":"ICD-NBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kne-shin exo sng axi mnl loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5710","description":"Kne-shin exo sng axi mnl loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE0","description":"ICD-CBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD1","description":"ICD-MCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF1","description":"ICD-OLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE0","description":"ICD-BDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD1","description":"ICD-NHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB1","description":"ICD-NDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4D","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot drop splint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4398","description":"Foot drop splint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC0","description":"ICD-CBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED1","description":"ICD-NFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF1","description":"ICD-KAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD0","description":"ICD-ODUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA1","description":"ICD-NCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assert comm tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0040","description":"Assert comm tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC0","description":"ICD-OGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF1","description":"ICD-MBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34833","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA226","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0014","description":"Other power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneum compres w/cal pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0652","description":"Pneum compres w/cal pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjustment of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9948","description":"Adjustment of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC0","description":"ICD-FFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB1","description":"ICD-BEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2119","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA1","description":"ICD-CEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Map tachycardia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93609","description":"Map tachycardia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cephalin floculation test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2028","description":"Cephalin floculation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE0","description":"ICD-FGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF1","description":"ICD-KCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD0","description":"ICD-ECAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE0","description":"ICD-GBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE0","description":"ICD-BELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE134","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE1","description":"ICD-NEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA1","description":"ICD-FGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7548","description":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB1","description":"ICD-ECUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66762","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Omalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2357","description":"Omalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD1","description":"ICD-NGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial hospitalization serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0201","description":"Partial hospitalization serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht musc image planar mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78454","description":"Ht musc image planar mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23625","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interphalangeal joint repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8659","description":"Interphalangeal joint repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE0","description":"ICD-PDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE0","description":"ICD-LASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurg ablate fa each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19105","description":"Cryosurg ablate fa each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35537","description":"Art byp grft aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87806","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC33","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0576","description":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0690U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690U","description":"CPT-0690U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of digoxin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80163","description":"Assay of digoxin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA0","description":"ICD-KIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB0","description":"ICD-HGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2930","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF1","description":"ICD-ECMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD0","description":"ICD-CDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp spenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35636","description":"Art byp spenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB31","description":"ICD-2BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC1","description":"ICD-KGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88165","description":"Cytopath tbs c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9024","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME0","description":"ICD-KBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9313","description":"HCPCS-C9313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ven thrombosis images bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78458","description":"Ven thrombosis images bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE0","description":"ICD-MEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF1","description":"ICD-OKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB1","description":"ICD-GIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2A","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carfilzomib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9047","description":"Injection_ carfilzomib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement air bubble detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1530","description":"Replacement air bubble detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF0","description":"ICD-BGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB0","description":"ICD-KINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF0","description":"ICD-BAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ doxercalciferol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1270","description":"Injection_ doxercalciferol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB31","description":"ICD-1BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB0","description":"ICD-EDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dry pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0199","description":"Dry pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA235","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB0","description":"ICD-BFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9729","description":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optx of rib fx w/fixj scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21811","description":"Optx of rib fx w/fixj scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE0","description":"ICD-LCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no offer eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9381","description":"Doc med reas no offer eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45309","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clotting assay whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85396","description":"Clotting assay whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6197","description":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF1","description":"ICD-OEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF1","description":"ICD-NCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Negative pressure ventilator; portable or stationary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0460","description":"Negative pressure ventilator; portable or stationary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50526","description":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE1","description":"ICD-AACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1034","description":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57505","description":"Endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87560","description":"M.avium-intra dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay secretory type ii pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423T","description":"Assay secretory type ii pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision pericoronal gingiva","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7971","description":"Excision pericoronal gingiva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE0","description":"ICD-OLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vaccine 3 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90746","description":"Hepb vaccine 3 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE1","description":"ICD-CDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sitz type bath or equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0160","description":"Sitz type bath or equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair throat esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42953","description":"Repair throat esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB1","description":"ICD-BGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA0","description":"ICD-CBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF0","description":"ICD-IDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE1","description":"ICD-LIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF0","description":"ICD-MKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap esophagomyotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2079","description":"Lap esophagomyotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98976","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo-afo cal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4110","description":"Repl leath cuff kafo-afo cal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC1","description":"ICD-HCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intraspinl lesion crv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63265","description":"Excise intraspinl lesion crv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0891T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268U","description":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB1","description":"ICD-AALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC0","description":"ICD-PJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF1","description":"ICD-EADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE1","description":"ICD-KCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99345","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35905","description":"Excision graft thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close mastoid fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69700","description":"Close mastoid fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC1","description":"ICD-MLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9956","description":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD1","description":"ICD-KEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sed rate automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85652","description":"Rbc sed rate automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB1","description":"ICD-KELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA1","description":"ICD-AGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99439","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006U","description":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE1","description":"ICD-MBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xi pta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85270","description":"Clot factor xi pta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX21","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE1","description":"ICD-HBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tun ip cath perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49418","description":"Insert tun ip cath perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC0","description":"ICD-JAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caries preventive medicament application - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1355","description":"Caries preventive medicament application - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1739","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1739","description":"HCPCS-C1739","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0661T","description":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC0","description":"ICD-GBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA1","description":"ICD-KAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB1","description":"ICD-BCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF1","description":"ICD-GIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6083","description":"Implant Supported Crown - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB0","description":"ICD-GFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA1","description":"ICD-FCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF0","description":"ICD-GFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27769","description":"Optx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC1","description":"ICD-AHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC0","description":"ICD-MACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB0","description":"ICD-JABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No eval opi use instr/intv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9585","description":"No eval opi use instr/intv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE1","description":"ICD-MEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE117","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0553U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","description":"CPT-0553U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD0","description":"ICD-OJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE0","description":"ICD-KAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA1","description":"ICD-OJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41018","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE1","description":"ICD-OFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB0","description":"ICD-NKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD1","description":"ICD-NFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC1","description":"ICD-OAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE1","description":"ICD-OCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF0","description":"ICD-FDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ankle joint open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27870","description":"Fusion of ankle joint open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA0","description":"ICD-AGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA0","description":"ICD-GEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67999","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC1","description":"ICD-FFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19086","description":"Bx breast add lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA1","description":"ICD-JFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8661","description":"Fun stat score ls pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC0","description":"ICD-MFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair narrowing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0969","description":"Wheelchair narrowing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9988","description":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF0","description":"ICD-FHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD0","description":"ICD-MICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB1","description":"ICD-KBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE0","description":"ICD-BEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31588","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE0","description":"ICD-NHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF1","description":"ICD-GAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD205","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB0","description":"ICD-NFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB0","description":"ICD-NFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28636","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE1","description":"ICD-KDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50722","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE0","description":"ICD-OIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4020","description":"Cast sup lng arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC105","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport lodgng recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0180","description":"Noner transport lodgng recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho flex pavlik harns pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1620","description":"Ho flex pavlik harns pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC206","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD1","description":"ICD-PEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA0","description":"ICD-FACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water circ heat pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0217","description":"Water circ heat pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serpina1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81332","description":"Serpina1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB1","description":"ICD-OCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF1","description":"ICD-NLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX07","description":"Low Rehab plus Extensive _ ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pessary_ disposable_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4564","description":"Pessary_ disposable_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF0","description":"ICD-JCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum deep <1.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28045","description":"Exc foot/toe tum deep <1.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF0","description":"ICD-EBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB0","description":"ICD-CDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec stains not for microorg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0477","description":"Spec stains not for microorg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE1","description":"ICD-BDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB0","description":"ICD-MLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specialty care transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0434","description":"Specialty care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0502","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF1","description":"ICD-ACAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA0","description":"ICD-GIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE1","description":"ICD-JGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA0","description":"ICD-FHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE1","description":"ICD-PBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise pharynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42808","description":"Excise pharynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB1","description":"ICD-FGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9051","description":"Blood_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ transpl pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2152","description":"Solid organ transpl pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8870","description":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tah rad dissect for debulk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58953","description":"Tah rad dissect for debulk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF0","description":"ICD-OAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB45","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Throat muscle surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43030","description":"Throat muscle surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0608U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","description":"CPT-0608U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB0","description":"ICD-KGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair throat wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42900","description":"Repair throat wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plerixafor injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2562","description":"Plerixafor injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD0","description":"ICD-BCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC31","description":"ICD-3JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE156","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA141","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0062U","description":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm transmitter ald","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5288","description":"Ald fm/dm transmitter ald","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD240","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8923","description":"2d tte w or w/o fol w/con_co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB1","description":"ICD-OHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF0","description":"ICD-ADCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA1","description":"ICD-GGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB0","description":"ICD-BCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA1","description":"ICD-CIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not medically possible because the patient was discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1147","description":"Ongoing care not medically possible because the patient was discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft een & lips","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15260","description":"Skin full graft een & lips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD0","description":"ICD-PGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ PRAME and LINC00518_ superficial collection using adhesive patch(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0089U","description":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ PRAME and LINC00518_ superficial collection using adhesive patch(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1212","description":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy bronch stents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31636","description":"Bronchoscopy bronch stents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opiate(s)_ drug and metabolites_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6056","description":"Opiate(s)_ drug and metabolites_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA23","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA0","description":"ICD-BFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD0","description":"ICD-EAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC0","description":"ICD-JCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA1","description":"ICD-GBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD0","description":"ICD-GEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA1","description":"ICD-CCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling catheter special","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4340","description":"Indwelling catheter special","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost s/d acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7405","description":"Add ue prost s/d acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0546T","description":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA0","description":"ICD-KHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6576","description":"Gradient compression arm sleeve_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA0","description":"ICD-ABAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC204","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA1","description":"ICD-FFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post-op hip abduct custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1685","description":"Post-op hip abduct custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC0","description":"ICD-JBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneuma/vac walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4361","description":"Pneuma/vac walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD0","description":"ICD-GDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80505","description":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF0","description":"ICD-NAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD0","description":"ICD-BHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA0","description":"ICD-JECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF1","description":"ICD-PFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452U","description":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE0","description":"ICD-CCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC0","description":"ICD-OIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC0","description":"ICD-GILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB1","description":"ICD-KGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF0","description":"ICD-PBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF0","description":"ICD-GFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3317F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50551","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drop lock retainer each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2785","description":"Drop lock retainer each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB0","description":"ICD-METB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35271","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA1","description":"ICD-OHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95725","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33511","description":"Cabg vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275U","description":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD1","description":"ICD-MDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy accessory convex inse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5093","description":"Ostomy accessory convex inse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0855T","description":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9763","description":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay for phencyclidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83992","description":"Assay for phencyclidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB0","description":"ICD-KGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01392","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","description":"CPT-01392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA1","description":"ICD-KAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE0","description":"ICD-OINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heavy metal screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83015","description":"Heavy metal screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87471","description":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF1","description":"ICD-KEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD0","description":"ICD-ODAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unresectab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9107","description":"Onc dx pancreatic unresectab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9186","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9186","description":"HCPCS-J9186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC0","description":"ICD-IHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD1","description":"ICD-OKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant hormone pellet(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11980","description":"Implant hormone pellet(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"West nile virus ab igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86788","description":"West nile virus ab igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC0","description":"ICD-CHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophoretic test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82664","description":"Electrophoretic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45320","description":"Proctosigmoidoscopy ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD1","description":"ICD-LCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81269","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE1","description":"ICD-IDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semi precision attach abut","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6052","description":"Semi precision attach abut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA1","description":"ICD-OEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB20","description":"High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD1","description":"ICD-KCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise prosth vag graft lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57426","description":"Revise prosth vag graft lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB0","description":"ICD-NLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","description":"CPT-01670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD1","description":"ICD-HDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1229","description":"Pediatric wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE0","description":"ICD-KEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD1","description":"ICD-OLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel implant sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7306","description":"Levonorgestrel implant sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC0","description":"ICD-CCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4157F","description":"Hep b vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0853","description":"Pwc gp 3 vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9804","description":"HCPCS-C9804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF0","description":"ICD-KGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE0","description":"ICD-CGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD1","description":"ICD-EECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81435","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC0","description":"ICD-AFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD0","description":"ICD-DESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv artific diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22856","description":"Cerv artific diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF0","description":"ICD-BCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA0","description":"ICD-OFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csi per asx pt w/pci 2 yrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8963","description":"Csi per asx pt w/pci 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE0","description":"ICD-FENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC0","description":"ICD-KDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50120","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF0","description":"ICD-OIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99349","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE0","description":"ICD-GBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA1","description":"ICD-OFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC0","description":"ICD-MLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC1","description":"ICD-HISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB0","description":"ICD-BHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE1","description":"ICD-ODTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB1","description":"ICD-CEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/videorecord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95951","description":"Eeg monitoring/videorecord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0508T","description":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57200","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF0","description":"ICD-NAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Male external catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4326","description":"Male external catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC1","description":"ICD-NDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE1","description":"ICD-KHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin sys stance flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5845","description":"Knee-shin sys stance flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"7 field photo interp doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2024F","description":"7 field photo interp doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serum lvls ca/ipth/lpd ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3278F","description":"Serum lvls ca/ipth/lpd ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28297","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF1","description":"ICD-IDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8866","description":"Doc pt reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle transfers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23397","description":"Muscle transfers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE0","description":"ICD-KGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/repair hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69711","description":"Remove/repair hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1224","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF1","description":"ICD-MGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","description":"CPT-01234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE0","description":"ICD-AAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1096","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3b-4 metasta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9066","description":"Onc dx nsclc stg3b-4 metasta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath eval fna report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88173","description":"Cytopath eval fna report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA0","description":"ICD-GAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD0","description":"ICD-GDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv-hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90697","description":"Dtap-ipv-hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brca2 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81217","description":"Brca2 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD0","description":"ICD-LGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9358","description":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA1","description":"ICD-GBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/up stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52342","description":"Cysto w/up stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD0","description":"ICD-JCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC1","description":"ICD-EGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Permanent tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4263","description":"Permanent tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 100-300","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88275","description":"Cytogenetics 100-300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE1","description":"ICD-IDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE0","description":"ICD-JGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF1","description":"ICD-GIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF0","description":"ICD-OBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"VEKLURY - Injection_ remdesivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0248","description":"VEKLURY - Injection_ remdesivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA0","description":"ICD-NEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pentazocine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3070","description":"Pentazocine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trichinella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86784","description":"Trichinella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA1","description":"ICD-JCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniocentesis therapeutic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59001","description":"Amniocentesis therapeutic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bed safety enclosure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0316","description":"Bed safety enclosure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB0","description":"ICD-JDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA1","description":"ICD-FIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD145","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC0","description":"ICD-MJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC1","description":"ICD-OKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB0","description":"ICD-BEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD0","description":"ICD-FGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB1","description":"ICD-FCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA0","description":"ICD-NGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3221","description":"Orthopedic mens shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc fe+ stores b/4 epo thx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3160F","description":"Doc fe+ stores b/4 epo thx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA0","description":"ICD-EHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of b hexosaminidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83080","description":"Assay of b hexosaminidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB1","description":"ICD-OBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED0","description":"ICD-IHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE1","description":"ICD-CGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC0","description":"ICD-OCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC1","description":"ICD-JCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB0","description":"ICD-NECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF0","description":"ICD-KFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray strenoclavic jt 3/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71130","description":"X-ray strenoclavic jt 3/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF1","description":"ICD-NBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no disc tx opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9400","description":"Doc reas no disc tx opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE0","description":"ICD-FDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD1","description":"ICD-KGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87477","description":"Lyme dis dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA0","description":"ICD-NAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB1","description":"ICD-CGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES135","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB1","description":"ICD-BDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA0","description":"ICD-BBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE0","description":"ICD-LBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75605","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA140","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26750","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast percut w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19100","description":"Bx breast percut w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5261","description":"Hearing aid_ digit_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA1","description":"ICD-BDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bladder irrigation tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4355","description":"Bladder irrigation tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD256","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75982","description":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF1","description":"ICD-GHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC0","description":"ICD-BFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF1","description":"ICD-FEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA0","description":"ICD-BFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA0","description":"ICD-JAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC0","description":"ICD-CGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB1","description":"ICD-BDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable sensor_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9276","description":"Disposable sensor_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF1","description":"ICD-OIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0704","description":"HCPCS-A0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67560","description":"Revise eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB0","description":"ICD-GCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD1","description":"ICD-OJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF1","description":"ICD-BFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protozoa antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86753","description":"Protozoa antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA0","description":"ICD-NDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlmyd/gonrh tsts docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3511F","description":"Chlmyd/gonrh tsts docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Navigational bronchoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31627","description":"Navigational bronchoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ etelcalcetide_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0606","description":"Injection_ etelcalcetide_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE1","description":"ICD-FBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD0","description":"ICD-AABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagomyotomy abdominal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43330","description":"Esophagomyotomy abdominal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0940T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","description":"CPT-0940T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF0","description":"ICD-OFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE0","description":"ICD-GATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air fluidized bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0194","description":"Air fluidized bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 2 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0398","description":"Home sleep test/type 2 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1013","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD1","description":"ICD-CCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients receiving high doses of immunosuppressive therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1063","description":"Patients receiving high doses of immunosuppressive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPE1","description":"ICD-CDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g potassium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2540","description":"Penicillin g potassium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2526","description":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE0","description":"ICD-OKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB0","description":"ICD-OHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE0","description":"ICD-FFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB0","description":"ICD-JDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Draw blood off venous device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36591","description":"Draw blood off venous device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77401","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tibial length sock fx or equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2840","description":"Tibial length sock fx or equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36245","description":"Ins cath abd/l-ext art 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC0","description":"ICD-FHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB32","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA1","description":"ICD-KIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ann breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0613","description":"Ann breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fall plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518F","description":"Fall plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8090","description":"Compre dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ant resin-based cmpst crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2390","description":"Ant resin-based cmpst crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB1","description":"ICD-FBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine culture/colony count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87086","description":"Urine culture/colony count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF1","description":"ICD-JBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD0","description":"ICD-OJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26700","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC0","description":"ICD-GDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echosclerotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2202","description":"Echosclerotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB11","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest art for cabg add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35600","description":"Harvest art for cabg add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB0","description":"ICD-NLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB1","description":"ICD-OEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA1","description":"ICD-CHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF1","description":"ICD-CBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31241","description":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD112","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace chst cmprss sys hose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7026","description":"Replace chst cmprss sys hose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditor evoke potent limit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92586","description":"Auditor evoke potent limit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD1","description":"ICD-DDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0042","description":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8473","description":"Ace/arb thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC0","description":"ICD-CGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00870","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","description":"CPT-00870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd demo bundle-level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9014","description":"Esrd demo bundle-level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD254","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB1","description":"ICD-OKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4226","description":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL26","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md inr test revie inter mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0250","description":"Md inr test revie inter mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF0","description":"ICD-AHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw <4views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70100","description":"X-ray exam of jaw <4views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF1","description":"ICD-MDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urea nitrogen semi-quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84525","description":"Urea nitrogen semi-quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF0","description":"ICD-KACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF1","description":"ICD-KCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD0","description":"ICD-GCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement impl pump cathet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0785","description":"Replacement impl pump cathet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate leg veins open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37761","description":"Ligate leg veins open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC240","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA0","description":"ICD-IHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD1","description":"ICD-OIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cbl dir f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6582","description":"Wrist/elbow bowden cbl dir f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF0","description":"ICD-KHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB1","description":"ICD-GBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8667","description":"Fun stat score ue >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA0","description":"ICD-HHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4318","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","description":"HCPCS-A4318","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32486","description":"Sleeve lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC0","description":"ICD-BCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost s/d ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7402","description":"Add ue prost s/d ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052A","description":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phototherapy light w/ photom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0202","description":"Phototherapy light w/ photom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0674U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674U","description":"CPT-0674U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF1","description":"ICD-NBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdo back wall lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76775","description":"Us exam abdo back wall lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly XT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4197","description":"PuraPly XT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vbac class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9439","description":"Vbac class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD0","description":"ICD-JHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF0","description":"ICD-KEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular imp_ aqueous drain de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1783","description":"Ocular imp_ aqueous drain de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0704","description":"CDT-D0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54112","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA0","description":"ICD-CHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87799","description":"Detect agent nos dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01180","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","description":"CPT-01180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Romiplostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2796","description":"Romiplostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE1","description":"ICD-BAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF1","description":"ICD-MEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Outrigger bil w/ vert extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1085","description":"Outrigger bil w/ vert extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/o pat by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99368","description":"Team conf w/o pat by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC0","description":"ICD-MDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA0","description":"ICD-NFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tdap vaccine 7 yrs/> im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90715","description":"Tdap vaccine 7 yrs/> im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC1","description":"ICD-CDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28308","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML43","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF0","description":"ICD-EEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA0","description":"ICD-KHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemipelvect canad sing axis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5280","description":"Hemipelvect canad sing axis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE1","description":"ICD-FIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93318","description":"Echo transesophageal intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD0","description":"ICD-GBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE1","description":"ICD-BBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF1","description":"ICD-PBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE0","description":"ICD-FFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC213","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2361","description":"HCPCS-J2361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99236","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA0","description":"ICD-JBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5211","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC0","description":"ICD-PCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE1","description":"ICD-HIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81110","description":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB1","description":"ICD-BFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42825","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1951","description":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC31","description":"ICD-3IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB254","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL06","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225U","description":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB0","description":"ICD-PGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67850","description":"Treat eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31531","description":"Laryngoscopy w/fb & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD1","description":"ICD-HGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB0","description":"ICD-GHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41105","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD0","description":"ICD-BFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC1","description":"ICD-OAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histochemical stains add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88314","description":"Histochemical stains add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD0","description":"ICD-CHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC1","description":"ICD-CCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27059","description":"Resect hip/pelv tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD1","description":"ICD-GAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA1","description":"ICD-FFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advncd care plan addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99498","description":"Advncd care plan addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC1","description":"ICD-FCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cath care noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5497","description":"Hit cath care noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB1","description":"ICD-NDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB1","description":"ICD-NJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl exhalation port for pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7045","description":"Repl exhalation port for pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87528","description":"Hsv dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX41","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose/normal saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7042","description":"5% dextrose/normal saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF0","description":"ICD-GHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33684","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA0","description":"ICD-KASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF0","description":"ICD-KAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo intralesional over 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96406","description":"Chemo intralesional over 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC0","description":"ICD-AGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF0","description":"ICD-HIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00350","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","description":"CPT-00350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD1","description":"ICD-JEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37255","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","description":"CPT-37255","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF0","description":"ICD-OFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA0","description":"ICD-IECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB0","description":"ICD-BHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric recurrent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9103","description":"Onc dx gastric recurrent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB1","description":"ICD-FALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA0","description":"ICD-NGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE0","description":"ICD-EALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB231","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE1","description":"ICD-EAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF0","description":"ICD-BIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets Pathogen Reduced Ea Unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9988","description":"Platelets Pathogen Reduced Ea Unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2002","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA160","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD1","description":"ICD-EABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA0","description":"ICD-ADEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD1","description":"ICD-KBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE0","description":"ICD-FFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam breastbone 2/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71120","description":"X-ray exam breastbone 2/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB0","description":"ICD-GBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF1","description":"ICD-CALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9705","description":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB0","description":"ICD-AFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE0","description":"ICD-NECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE1","description":"ICD-OFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF0","description":"ICD-GCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE0","description":"ICD-OAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA1","description":"ICD-LIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6212","description":"Bridge noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0239","description":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE0","description":"ICD-OFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB1","description":"ICD-GGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF0","description":"ICD-CGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11604","description":"Exc tr-ext mal+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA54","description":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC0","description":"ICD-CAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE1","description":"ICD-JCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA0","description":"ICD-FEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE1","description":"ICD-FIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Second stage implant surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6011","description":"Second stage implant surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peri-px device eval & prgr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93287","description":"Peri-px device eval & prgr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA0","description":"ICD-FBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB1","description":"ICD-EFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419U","description":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1000T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","description":"CPT-1000T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB1","description":"ICD-BGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immed mand part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5224","description":"Immed mand part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD1","description":"ICD-HEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9057","description":"Injection_ cetirizine hydrochloride_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB36","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF0","description":"ICD-ICTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ femur_ two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73550","description":"Radiologic examination_ femur_ two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med admin_ not oral/inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1503","description":"Med admin_ not oral/inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA1","description":"ICD-OJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainable rubber pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4378","description":"Drainable rubber pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA0","description":"ICD-GDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA1","description":"ICD-GBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rigid ped w/c tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1231","description":"Rigid ped w/c tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA1","description":"ICD-NDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC1","description":"ICD-CGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2722","description":"Crown resin w/ noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orbital replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5928","description":"Orbital replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE1","description":"ICD-OGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01380","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","description":"CPT-01380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE1","description":"ICD-OGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED1","description":"ICD-KIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD1","description":"ICD-PBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Im admin 1st/only component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90460","description":"Im admin 1st/only component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME0","description":"ICD-GEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC0","description":"ICD-CGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52204","description":"Cystoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA1","description":"ICD-NGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB1","description":"ICD-CGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB1","description":"ICD-BGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replc vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316T","description":"Replc vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0514U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","description":"CPT-0514U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8014","description":"HCPCS-C8014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA21","description":"ICD-2IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6525","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC0","description":"ICD-FBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB0","description":"ICD-OILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF0","description":"ICD-KFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC0","description":"ICD-FGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40520","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44314","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB1","description":"ICD-DESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC1","description":"ICD-BEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01462","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","description":"CPT-01462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wig any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9282","description":"Wig any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF1","description":"ICD-LBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF0","description":"ICD-BHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30150","description":"Partial removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esano aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4275","description":"Esano aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA1","description":"ICD-MBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES334","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA0","description":"ICD-JHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB1","description":"ICD-OFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil prevoc waiver per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2015","description":"Habil prevoc waiver per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flu imm no admin doc rea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8483","description":"Flu imm no admin doc rea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA11","description":"ICD-2FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD1","description":"ICD-GFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27520","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA0","description":"ICD-JFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA1","description":"ICD-CBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC0","description":"ICD-HGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC0","description":"ICD-LFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0457","description":"Injection_ aztreonam_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD0","description":"ICD-NHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2409","description":"Fetal surg noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX35","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB34","description":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33859","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35372","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9260","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC1","description":"ICD-CAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personalized_ anterior and lateral interbody cage (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1831","description":"Personalized_ anterior and lateral interbody cage (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA1","description":"ICD-NDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27440","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF1","description":"ICD-JCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54438","description":"Replantation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB1","description":"ICD-NIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87301","description":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC1","description":"ICD-CHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF1","description":"ICD-EHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","description":"CPT-01932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long qt synd known fam var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81281","description":"Long qt synd known fam var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC0","description":"ICD-MKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB1","description":"ICD-JICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA0","description":"ICD-FILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE1","description":"ICD-OIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD1","description":"ICD-OLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Camisole post-mast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8460","description":"Camisole post-mast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD1","description":"ICD-KEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD1","description":"ICD-FFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC0","description":"ICD-KIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54860","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis training incompl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90993","description":"Dialysis training incompl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD0","description":"ICD-IEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1457","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","description":"HCPCS-M1457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30300","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF1","description":"ICD-MGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert electrodes for eeg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95830","description":"Insert electrodes for eeg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC1","description":"ICD-FIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63300","description":"Remove vert xdrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC0","description":"ICD-OACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA0","description":"ICD-IBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj biperiden lactate/5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0190","description":"Inj biperiden lactate/5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE1","description":"ICD-GGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD0","description":"ICD-NCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD1","description":"ICD-AAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB1","description":"ICD-FFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC0","description":"ICD-JFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE0","description":"ICD-IEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pelvic organ surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84851","description":"Anesth pelvic organ surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8992","description":"Other pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD1","description":"ICD-NAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB20","description":"Ultra High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF1","description":"ICD-EHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33619","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD1","description":"ICD-CFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9913","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9913","description":"CDT-D9913","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD0","description":"ICD-DCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA1","description":"ICD-CEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","description":"CPT-01860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD0","description":"ICD-CFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD1","description":"ICD-AFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC0","description":"ICD-KDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC1","description":"ICD-GCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD0","description":"ICD-KFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual semi-reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1225","description":"Manual semi-reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC1","description":"ICD-AGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0512U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","description":"CPT-0512U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7668","description":"Metaproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefoperazone sod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0021","description":"Injection_ cefoperazone sod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA0","description":"ICD-NFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA60","description":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA0","description":"ICD-PCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD0","description":"ICD-NHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB112","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unplnd ret to surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9308","description":"Unplnd ret to surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentistry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0067","description":"Dentistry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD1","description":"ICD-FCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC0","description":"ICD-JEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So 8 abd restraint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3650","description":"So 8 abd restraint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60254","description":"Extensive thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB0","description":"ICD-ABEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0669T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC1","description":"ICD-GBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound therapy pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2402","description":"Neg press wound therapy pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE0","description":"ICD-BINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF0","description":"ICD-CCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF1","description":"ICD-KHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD0","description":"ICD-AFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA1","description":"ICD-NCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC0","description":"ICD-ABDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD0","description":"ICD-EHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calculated 10-year ascvd risk score of = 20 percent during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1364","description":"Calculated 10-year ascvd risk score of = 20 percent during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC0","description":"ICD-NJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB1","description":"ICD-JDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26210","description":"Removal of finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB0","description":"ICD-BDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME0","description":"ICD-BGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0704","description":"HCPCS-C0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screw retained plate","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7292","description":"Screw retained plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC21","description":"ICD-4DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1089T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1089T","description":"CPT-1089T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Locm 100-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9965","description":"Locm 100-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC0","description":"ICD-MILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0539","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","description":"HCPCS-G0539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not eligible ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8936","description":"Pt not eligible ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD0","description":"ICD-GELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF1","description":"ICD-MAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlh uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58572","description":"Tlh uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35261","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF0","description":"ICD-OGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA1","description":"ICD-KHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76519","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26200","description":"Remove hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC1","description":"ICD-FGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ixabepilone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9207","description":"Ixabepilone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2076","description":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31233","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC1","description":"ICD-CIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic standing frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0642","description":"Dynamic standing frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB0","description":"ICD-OLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA1","description":"ICD-IAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urethral insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4336","description":"Urethral insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB11","description":"ICD-1FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99474","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402U","description":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA0","description":"ICD-OKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43337","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cvd risk assessment performed_ have a documented calculated risk score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1258","description":"Cvd risk assessment performed_ have a documented calculated risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply interstit radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77778","description":"Apply interstit radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF1","description":"ICD-BGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF0","description":"ICD-BBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko w/0 joint rigid molded to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1834","description":"Ko w/0 joint rigid molded to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE1","description":"ICD-DCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25210","description":"Removal of wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE0","description":"ICD-CFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Npm1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81310","description":"Npm1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01996","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","description":"CPT-01996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86325","description":"Other immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD1","description":"ICD-OJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD0","description":"ICD-OGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE1","description":"ICD-JGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA1","description":"ICD-CGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prostatic rf thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53852","description":"Prostatic rf thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD0","description":"ICD-NIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg urin trac obstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2401","description":"Fetal surg urin trac obstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF1","description":"ICD-JIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA0","description":"ICD-BIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA0","description":"ICD-KIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF1","description":"ICD-LFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA0","description":"ICD-FCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD0","description":"ICD-NIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC1","description":"ICD-NDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB0","description":"ICD-GHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL16","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove uterus after cesarean","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59525","description":"Remove uterus after cesarean","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD1","description":"ICD-ICAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2600","description":"Hip clevis/thrust bearing fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn not hi rsk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0121","description":"Colon ca scrn not hi rsk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB1","description":"ICD-KFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; one view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73500","description":"Radiologic examination_ hip_ unilateral; one view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heel leather reinforced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3440","description":"Heel leather reinforced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC1","description":"ICD-OCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND1","description":"ICD-KFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF1","description":"ICD-CBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8X","description":"Very High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35141","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0813","description":"Pwc gp 1 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC1","description":"ICD-OFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF0","description":"ICD-KCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF1","description":"ICD-JEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA0","description":"ICD-OIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC1","description":"ICD-OEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD220","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43246","description":"Egd place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD1","description":"ICD-AGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB1","description":"ICD-HHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA0","description":"ICD-KGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC0","description":"ICD-GGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed appliance therapy habt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8220","description":"Fixed appliance therapy habt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF0","description":"ICD-LCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE0","description":"ICD-JCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC1","description":"ICD-CABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF0","description":"ICD-GELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF1","description":"ICD-GDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB1","description":"ICD-ICDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50620","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC0","description":"ICD-JELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB1","description":"ICD-NFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92312","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuroeltrd stim post tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64566","description":"Neuroeltrd stim post tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reaching/grabbing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9281","description":"Reaching/grabbing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA0","description":"ICD-NBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD0","description":"ICD-BAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB1","description":"ICD-MEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13131","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA0","description":"ICD-GHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA0","description":"ICD-FFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"repair cast partial framework_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5622","description":"repair cast partial framework_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25105","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE1","description":"ICD-CGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE0","description":"ICD-BHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-routine bl draw 3/> yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36410","description":"Non-routine bl draw 3/> yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE1","description":"ICD-OCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF0","description":"ICD-CFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB1","description":"ICD-OHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m tetrofosmin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9502","description":"Tc99m tetrofosmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73060","description":"X-ray exam of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7546","description":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB1","description":"ICD-FIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","description":"CPT-37272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cogenex Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4229","description":"Cogenex Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA1","description":"ICD-OFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD1","description":"ICD-NDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stereoisomer analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80374","description":"Stereoisomer analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parathyrd planar w/spect&ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78072","description":"Parathyrd planar w/spect&ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB0","description":"ICD-MKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43453","description":"Dilate esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD0","description":"ICD-EFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF0","description":"ICD-EDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB1","description":"ICD-NCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01490","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","description":"CPT-01490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by birth a doula birth workers_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1032","description":"Services performed by birth a doula birth workers_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE1","description":"ICD-NBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF0","description":"ICD-OAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA1","description":"ICD-JDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB1","description":"ICD-OJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC0","description":"ICD-OHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD1","description":"ICD-CBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE0","description":"ICD-NBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61526","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt/caregiver counsel safety","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6090F","description":"Pt/caregiver counsel safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30117","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4214","description":"Cellesta cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0676","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0676","description":"HCPCS-G0676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB1","description":"ICD-MEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temple bone implant revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69717","description":"Temple bone implant revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF1","description":"ICD-NCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc cur meds by prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8427","description":"Doc cur meds by prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE0","description":"ICD-NLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rho(d) immune globulin h_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2792","description":"Rho(d) immune globulin h_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA31","description":"ICD-2AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43632","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID1","description":"ICD-NLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB60","description":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lancet device each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4258","description":"Lancet device each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD1","description":"ICD-CDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert cath pleura w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32556","description":"Insert cath pleura w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54001","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF0","description":"ICD-CFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC21","description":"ICD-1BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5103","description":"HCPCS-A5103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID0","description":"ICD-MHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy dx sep proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58555","description":"Hysteroscopy dx sep proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC0","description":"ICD-NCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE0","description":"ICD-CCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped specmetabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4162","description":"Ef ped specmetabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29819","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant from hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26320","description":"Removal of implant from hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE1","description":"ICD-KIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antistreptolysin o titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86060","description":"Antistreptolysin o titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34712","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC0","description":"ICD-JCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42800","description":"Biopsy of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA0","description":"ICD-EFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78264","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscp harv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2112","description":"Knee arthroscp harv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC1","description":"ICD-HHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD0","description":"ICD-ADCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA1","description":"ICD-JGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87526","description":"Hepatitis g dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE1","description":"ICD-NGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9297","description":"No doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8G","description":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF0","description":"ICD-CGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE1","description":"ICD-IFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE1","description":"ICD-NGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB11","description":"ICD-3JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9801","description":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC1","description":"ICD-KFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE1","description":"ICD-EFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA1","description":"ICD-AEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB0","description":"ICD-OHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC0","description":"ICD-JITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD1","description":"ICD-CDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA212","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6112","description":"Imp/abut rem dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC0","description":"ICD-OAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26516","description":"Fusion of knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wc planar back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2621","description":"Wc planar back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF0","description":"ICD-GBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whfo electric custom fitted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3904","description":"Whfo electric custom fitted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC0","description":"ICD-CBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","description":"HCPCS-E1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC1","description":"ICD-BBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD1","description":"ICD-FHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0813T","description":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB0","description":"ICD-JEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE0","description":"ICD-FIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear impression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5275","description":"Ear impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy not rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8475","description":"Ace/arb thxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF0","description":"ICD-AHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Vedolizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9026","description":"Injection_ Vedolizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","description":"CPT-00882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD1","description":"ICD-OAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB1","description":"ICD-CFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB1","description":"ICD-OKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF0","description":"ICD-GHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special anesthesia service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99100","description":"Special anesthesia service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA1","description":"ICD-KIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA0","description":"ICD-NGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF0","description":"ICD-ABIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD1","description":"ICD-CBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF0","description":"ICD-IACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD0","description":"ICD-LGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69632","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8D","description":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC11","description":"ICD-2KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA0","description":"ICD-AIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63688","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD1","description":"ICD-OBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD1","description":"ICD-OAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD1","description":"ICD-DCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF0","description":"ICD-GBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE0","description":"ICD-EGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF0","description":"ICD-FHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF0","description":"ICD-KDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC1","description":"ICD-GDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97129","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0525","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","description":"HCPCS-J0525","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC1","description":"ICD-MJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE0","description":"ICD-IBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE0","description":"ICD-JAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"T-cell depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38210","description":"T-cell depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB1","description":"ICD-NKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME1","description":"ICD-EAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC0","description":"ICD-KHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"App topical fluoride varnish","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99188","description":"App topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA21","description":"ICD-1IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Circumcision w/regionl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54150","description":"Circumcision w/regionl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81596","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC1","description":"ICD-NHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4C","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam spinal canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76800","description":"Us exam spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA1","description":"ICD-IIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC0","description":"ICD-GGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8I","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE0","description":"ICD-NHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF0","description":"ICD-NDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB1","description":"ICD-FDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1C","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35111","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","description":"HCPCS-A2034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD1","description":"ICD-KFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF0","description":"ICD-EAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv parasym inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95921","description":"Autonomic nrv parasym inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE0","description":"ICD-CAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69729","description":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2B","description":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD0","description":"ICD-CGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj prohance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9576","description":"Inj prohance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75898","description":"Follow-up angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF0","description":"ICD-FEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD0","description":"ICD-NDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF0","description":"ICD-FCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA1","description":"ICD-MBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No wet-dry drssings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4266F","description":"No wet-dry drssings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC1","description":"ICD-NEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1017","description":"Targeted case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0513U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","description":"CPT-0513U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC0","description":"ICD-IAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq tx nasoethmoid fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21340","description":"Perq tx nasoethmoid fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drnble ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5062","description":"Drnble ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3348","description":"Retreat root canal molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF1","description":"ICD-KCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lung hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32800","description":"Repair lung hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB0","description":"ICD-CARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB0","description":"ICD-MDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99 tilmanocept diag 0.5mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9520","description":"Tc99 tilmanocept diag 0.5mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB0","description":"ICD-KBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF1","description":"ICD-CEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA210","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD1","description":"ICD-LAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE0","description":"ICD-CEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE1","description":"ICD-CAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC1","description":"ICD-KHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC23","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polysom any age 1-3> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95808","description":"Polysom any age 1-3> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iron stain peripheral blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85536","description":"Iron stain peripheral blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA1","description":"ICD-FINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0806T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA0","description":"ICD-OHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA11","description":"ICD-2LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB1","description":"ICD-PBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behind ear hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5060","description":"Behind ear hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD1","description":"ICD-FEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA1","description":"ICD-OIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HISTOPLASM CAPSULATUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87385","description":"IAAD IA HISTOPLASM CAPSULATUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD0","description":"ICD-LDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB1","description":"ICD-AEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit stoma care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99505","description":"Home visit stoma care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC1","description":"ICD-PBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65810","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0260U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Uti Bill Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9684","description":"Onsite Ac C Tx Nsg Fac Res Uti Bill Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92606","description":"Non-speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28307","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85420","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0859T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB1","description":"ICD-JGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF1","description":"ICD-OKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC1","description":"ICD-MBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB1","description":"ICD-NJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colon motility 6 hr study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91117","description":"Colon motility 6 hr study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB1","description":"ICD-PIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB1","description":"ICD-HFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD0","description":"ICD-KFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA0","description":"ICD-CDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD0","description":"ICD-FAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF1","description":"ICD-KHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monitor elec or comb vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0484","description":"Monitor elec or comb vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD1","description":"ICD-BGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0223","description":"Injection_ givosiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF0","description":"ICD-AHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0665","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","description":"HCPCS-G0665","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood smear interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85060","description":"Blood smear interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA20","description":"Ultra High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mult mech switches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2322","description":"Mult mech switches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84155","description":"Assay of protein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amb infusion pump mechanical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0779","description":"Amb infusion pump mechanical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bicarbonate conc sol per gal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4706","description":"Bicarbonate conc sol per gal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic compression device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0675","description":"Pneumatic compression device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA0","description":"ICD-GIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE0","description":"ICD-KDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB0","description":"ICD-CALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF0","description":"ICD-JGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES211","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of cheek nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64734","description":"Incision of cheek nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE0","description":"ICD-JHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC56","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86617","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76828","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF0","description":"ICD-GAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thiamine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3411","description":"Thiamine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sm 153 lexidronam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9604","description":"Sm 153 lexidronam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Itraconazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1835","description":"Itraconazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA0","description":"ICD-JHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE0","description":"ICD-PBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of scleral staphyloma; without graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66220","description":"Repair of scleral staphyloma; without graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percut allergy skin tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95004","description":"Percut allergy skin tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60281","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB1","description":"ICD-HDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE1","description":"ICD-HCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA1","description":"ICD-KBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC1","description":"ICD-JHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED1","description":"ICD-EEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uv lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2755","description":"Uv lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-tibial shell molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2340","description":"Pre-tibial shell molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artacent wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4169","description":"Artacent wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61892","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for therapy guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77014","description":"Ct scan for therapy guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44384","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC0","description":"ICD-NGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA1","description":"ICD-KBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE1","description":"ICD-KBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","description":"CPT-37288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD0","description":"ICD-NKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE1","description":"ICD-CATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD215","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA0","description":"ICD-JIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD1","description":"ICD-EIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2025F","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Betamethasone acet&sod phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0702","description":"Betamethasone acet&sod phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer dome & mouthpiece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7016","description":"Nebulizer dome & mouthpiece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB1","description":"ICD-NCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34716","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE1","description":"ICD-NLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB1","description":"ICD-JGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5514","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6068","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0954T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","description":"CPT-0954T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA1","description":"ICD-JCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD1","description":"ICD-IHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC0","description":"ICD-ICLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB1","description":"ICD-FHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE1","description":"ICD-KBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA54","description":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniply_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4249","description":"Amniply_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA0","description":"ICD-GAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii typing hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81378","description":"Hla i & ii typing hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27610","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0989T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","description":"CPT-0989T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA21","description":"ICD-1EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB1","description":"ICD-LHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC0","description":"ICD-OGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA1","description":"ICD-OLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF1","description":"ICD-EEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4338","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","description":"HCPCS-Q4338","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF0","description":"ICD-MHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF1","description":"ICD-NDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE1","description":"ICD-GIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED0","description":"ICD-FEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA215","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED0","description":"ICD-FGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Woundplus membrane or e-graft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4277","description":"Woundplus membrane or e-graft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC134","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87590","description":"N.gonorrhoeae dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1444","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","description":"HCPCS-M1444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA1","description":"ICD-OKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF0","description":"ICD-KFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pentostatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9268","description":"Pentostatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27607","description":"Treat lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB1","description":"ICD-LCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE1","description":"ICD-KAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90851","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC1","description":"ICD-DHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF1","description":"ICD-MJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD0","description":"ICD-GFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB0","description":"ICD-PEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA0","description":"ICD-MGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC0","description":"ICD-OHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB1","description":"ICD-PKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF0","description":"ICD-AEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC1","description":"ICD-JEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Graftjacket xpress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4113","description":"Graftjacket xpress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF1","description":"ICD-GFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC1","description":"ICD-IDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA0","description":"ICD-DFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45393","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD1","description":"ICD-MLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE0","description":"ICD-ADTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF1","description":"ICD-FAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC104","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41800","description":"Drainage of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC1","description":"ICD-BIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0542T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC1","description":"ICD-FAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit simple cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5498","description":"Hit simple cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay three catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82384","description":"Assay three catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81425","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC1","description":"ICD-FALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7957","description":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA1","description":"ICD-KHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","description":"HCPCS-J9161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse non-nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36455","description":"Bl exchange/transfuse non-nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98003","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","description":"CPT-98003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME1","description":"ICD-BCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB1","description":"ICD-OJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF0","description":"ICD-JFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22319","description":"Treat odontoid fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE1","description":"ICD-NBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC1","description":"ICD-IFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1269","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0670","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0670","description":"HCPCS-G0670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1467","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","description":"HCPCS-M1467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0527U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","description":"CPT-0527U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC0","description":"ICD-FBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89257","description":"Sperm identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compl gift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4013","description":"Compl gift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB0","description":"ICD-DHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1040","description":"Medicaid certified community behavioral health clinic services_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21010","description":"Incision of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epiandrosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6049","description":"Epiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF0","description":"ICD-OLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Expiratory positive airway pressure intranasal resistance valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7049","description":"Expiratory positive airway pressure intranasal resistance valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER CELL AGGREGJ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206U","description":"NEURO ALZHEIMER CELL AGGREGJ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46700","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB0","description":"ICD-HHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA1","description":"ICD-DEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75731","description":"Artery x-rays adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD217","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Joint survey single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77077","description":"Joint survey single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC0","description":"ICD-LGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF0","description":"ICD-BAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC07","description":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB0","description":"ICD-MBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FlowerDerm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4179","description":"FlowerDerm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF0","description":"ICD-GHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1411","description":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB0","description":"ICD-FBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immune globulin_ powder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1566","description":"Immune globulin_ powder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0015","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA0","description":"ICD-JAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE1","description":"ICD-FHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37221","description":"Iliac revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0682T","description":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD0","description":"ICD-KIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME0","description":"ICD-FFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Performance Not Met: The Residual Change Score Is Less Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2167","description":"Performance Not Met: The Residual Change Score Is Less Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB0","description":"ICD-FHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87634","description":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8X","description":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61576","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aud rehab postling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92633","description":"Aud rehab postling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA0","description":"ICD-OAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC1","description":"ICD-DGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB1","description":"ICD-FDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC1","description":"ICD-GCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65875","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF1","description":"ICD-BHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE1","description":"ICD-EBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6579","description":"Gradient compression glove_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD206","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD0","description":"ICD-KIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD1","description":"ICD-JHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27664","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB0","description":"ICD-CAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC0","description":"ICD-BIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB0","description":"ICD-NFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1347","description":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF0","description":"ICD-PIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pca3 testing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3721","description":"Pca3 testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj secretin synthetic human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2850","description":"Inj secretin synthetic human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9140","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80424","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE0","description":"ICD-OGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF0","description":"ICD-JCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED1","description":"ICD-EFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","description":"CPT-00938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC0","description":"ICD-EHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97155","description":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59130","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alkalin batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4233","description":"Alkalin batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion reset pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96371","description":"Sc ther infusion reset pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA0","description":"ICD-JAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess vol mgmt not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8958","description":"Assess vol mgmt not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dipropylacetic acid free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80165","description":"Dipropylacetic acid free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD0","description":"ICD-CITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF1","description":"ICD-JFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA1","description":"ICD-KDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA0","description":"ICD-JEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sho heel count plast reinfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3430","description":"Sho heel count plast reinfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1023T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","description":"CPT-1023T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2251","description":"Injection_ midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE0","description":"ICD-GIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB0","description":"ICD-KCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC0","description":"ICD-DAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE1","description":"ICD-ODVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1412","description":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME1","description":"ICD-NCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF1","description":"ICD-CIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2186","description":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","description":"HCPCS-A2037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid repair/modifying","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5014","description":"Hearing aid repair/modifying","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC0","description":"ICD-KHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9958","description":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC0","description":"ICD-OCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE0","description":"ICD-EDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Site not small cell lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9285","description":"Site not small cell lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide for gi tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74340","description":"X-ray guide for gi tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and if positive then documented mitigation recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9922","description":"Safety concerns screen provided and if positive then documented mitigation recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE1","description":"ICD-KFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF0","description":"ICD-NEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abrasion lesions add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15787","description":"Abrasion lesions add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8012","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8012","description":"HCPCS-C8012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE0","description":"ICD-IEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31086","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32609","description":"Thoracoscopy w/bx pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0856T","description":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD1","description":"ICD-DBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB1","description":"ICD-FBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topotecan oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8705","description":"Topotecan oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB1","description":"ICD-OCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE1","description":"ICD-OJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1B","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC0","description":"ICD-BCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87339","description":"IAAD IA HPYLORI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF1","description":"ICD-GCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6020","description":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME0","description":"ICD-NAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59120","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1099","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Capsaicin 8% patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7336","description":"Capsaicin 8% patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE0","description":"ICD-LEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44146","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC0","description":"ICD-CEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB0","description":"ICD-IIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA1","description":"ICD-OFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND0","description":"ICD-FHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue not image intraop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8874","description":"Tissue not image intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99442","description":"Phone e/m phys/qhp 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD0","description":"ICD-HFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red cell mass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78120","description":"Red cell mass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1047T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1047T","description":"CPT-1047T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct metacarpal flaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26565","description":"Correct metacarpal flaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD1","description":"ICD-OLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA1","description":"ICD-IGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB1","description":"ICD-KDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC0","description":"ICD-JBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10005","description":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50694","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB136","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD1","description":"ICD-OCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB1","description":"ICD-GAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD0","description":"ICD-GIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX42","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB0","description":"ICD-CFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE0","description":"ICD-CGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ bupivacaine liposome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9290","description":"Inj_ bupivacaine liposome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acid perfusion of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91030","description":"Acid perfusion of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE0","description":"ICD-CIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide gi dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74360","description":"X-ray guide gi dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Given To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0031","description":"Palliative Care Services Given To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA1","description":"ICD-NFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip bone les super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27065","description":"Remove hip bone les super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthr0 w/debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29862","description":"Hip arthr0 w/debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA1","description":"ICD-GADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD0","description":"ICD-BGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE1","description":"ICD-NINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE0","description":"ICD-MACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery chrgr 12 volt utah/e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7366","description":"Battery chrgr 12 volt utah/e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD0","description":"ICD-KBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00126","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","description":"CPT-00126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22867","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7322","description":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9569","description":"Technetium tc-99m auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33681","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","description":"CPT-00732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93644","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB0","description":"ICD-KBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022U","description":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1324","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87592","description":"N.gonorrhoeae dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1901","description":"HCPCS-B1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC31","description":"ICD-2JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF0","description":"ICD-FFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD1","description":"ICD-NCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC1","description":"ICD-NEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE0","description":"ICD-CHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF1","description":"ICD-KHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1681","description":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF1","description":"ICD-KAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64680","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC1","description":"ICD-CDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF1","description":"ICD-KHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert cervical dilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59200","description":"Insert cervical dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF1","description":"ICD-ECAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC224","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB1","description":"ICD-FEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC0","description":"ICD-JGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF0","description":"ICD-KDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD1","description":"ICD-EBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1920","description":"Injection_ labetalol hydrochloride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC1","description":"ICD-OAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA0","description":"ICD-OGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery electrocorticogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95829","description":"Surgery electrocorticogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init ak ischal plstr direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5505","description":"Init ak ischal plstr direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC0","description":"ICD-BAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF1","description":"ICD-NLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA1","description":"ICD-IADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA1","description":"ICD-HFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE230","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onco (ovar) two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81500","description":"Onco (ovar) two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB1","description":"ICD-ECDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD1","description":"ICD-NJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX56","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc of neg or man pos tb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9360","description":"No doc of neg or man pos tb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD0","description":"ICD-CFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_hemodialysis_short-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1752","description":"Cath_hemodialysis_short-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0500","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB51","description":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES116","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99324","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65205","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA1","description":"ICD-NFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE1","description":"ICD-LDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB0","description":"ICD-DBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA1","description":"ICD-BBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267T","description":"Implt/rpl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA0","description":"ICD-DCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB0","description":"ICD-OCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE0","description":"ICD-OKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45395","description":"Lap removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC0","description":"ICD-IGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD1","description":"ICD-NELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE1","description":"ICD-JEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"H pylori (c-13) breath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83013","description":"H pylori (c-13) breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID1","description":"ICD-JGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pacing lead & connect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33224","description":"Insert pacing lead & connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB0","description":"ICD-NBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC1","description":"ICD-EBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9516","description":"Impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pontic-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6205","description":"Pontic-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC1","description":"ICD-AFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exercise w/hemodynamic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93464","description":"Exercise w/hemodynamic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE1","description":"ICD-GDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ sch team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9007","description":"Mccd_ sch team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change g-tube to g-j perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49446","description":"Change g-tube to g-j perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures mand part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5212","description":"Dentures mand part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED0","description":"ICD-EHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF0","description":"ICD-KIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mecasermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2170","description":"Mecasermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX15","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC1","description":"ICD-OHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lo flex l1-below l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0625","description":"Lo flex l1-below l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD1","description":"ICD-HBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF0","description":"ICD-GHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB0","description":"ICD-ACCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA0","description":"ICD-FCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ag detect nos ia single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87450","description":"Ag detect nos ia single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC1","description":"ICD-OJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB1","description":"ICD-AIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD0","description":"ICD-KHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE1","description":"ICD-JGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA0","description":"ICD-KBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE0","description":"ICD-AHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF1","description":"ICD-HBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE1","description":"ICD-NHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC212","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF1","description":"ICD-AETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4015","description":"Cast sup gauntlet ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE0","description":"ICD-JEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0905T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","description":"CPT-0905T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE0","description":"ICD-JAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB1","description":"ICD-CFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE1","description":"ICD-KFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC1","description":"ICD-IEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE1","description":"ICD-CDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE0","description":"ICD-JCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES321","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB1","description":"ICD-NHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asst oocyte fert case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4022","description":"Asst oocyte fert case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC1","description":"ICD-FEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA1","description":"ICD-AHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC0","description":"ICD-MAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9225","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9225","description":"CDT-D9225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD1","description":"ICD-FIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC13","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93151","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2209","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplt autol hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38241","description":"Transplt autol hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13133","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC0","description":"ICD-BHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull & brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62145","description":"Repair of skull & brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC1","description":"ICD-IFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB0","description":"ICD-OHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF0","description":"ICD-JFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Butorphanol tartrate_ nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0012","description":"Butorphanol tartrate_ nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted px extraocular musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67399","description":"Unlisted px extraocular musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF1","description":"ICD-ODMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF1","description":"ICD-BHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX40","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC0","description":"ICD-EBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD1","description":"ICD-KEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB0","description":"ICD-DAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40800","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24605","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal kidney open radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50230","description":"Removal kidney open radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transseptal fiberotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7291","description":"Transseptal fiberotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft iliac crest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20970","description":"Bone/skin graft iliac crest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE1","description":"ICD-JDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA0","description":"ICD-PJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA1","description":"ICD-ECBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB1","description":"ICD-BCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE1","description":"ICD-GEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396U","description":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC1","description":"ICD-CARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA0","description":"ICD-MGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90611","description":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES214","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80439","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA0","description":"ICD-OGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC1","description":"ICD-ABDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ciliary endoscopic ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66711","description":"Ciliary endoscopic ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Design custom breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19396","description":"Design custom breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB0","description":"ICD-ODEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21080","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF0","description":"ICD-FHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD0","description":"ICD-MKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand tum deep 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26113","description":"Exc hand tum deep 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","description":"HCPCS-Q0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF0","description":"ICD-CCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1263","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whelchr fxd full length arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1050","description":"Whelchr fxd full length arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF0","description":"ICD-IBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69955","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Newborn metabolic screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3620","description":"Newborn metabolic screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC156","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9174","description":"HCPCS-C9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA1","description":"ICD-GCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF0","description":"ICD-MGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6455","description":"Self-adher band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Weight mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9449","description":"Weight mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA0","description":"ICD-CIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME0","description":"ICD-KEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53085","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131_ Iobenguane_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9590","description":"Iodine I-131_ Iobenguane_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE124","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES140","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB0","description":"ICD-OBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE0","description":"ICD-PAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oth resp proc_ group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0239","description":"Oth resp proc_ group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0101","description":"HCPCS-C0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD0","description":"ICD-GBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0864T","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE1","description":"ICD-EBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF1","description":"ICD-BCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy lysis adhesn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7873","description":"Tmj arthroscopy lysis adhesn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5919","description":"Facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","description":"HCPCS-G0548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1036","description":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD1","description":"ICD-BGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD0","description":"ICD-PAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rib cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21230","description":"Rib cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC1","description":"ICD-KISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA1","description":"ICD-FHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C-1 esterase_ cinryze","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0598","description":"C-1 esterase_ cinryze","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27893","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest wall respiratory sensor electrode or electrode array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468T","description":"Removal of chest wall respiratory sensor electrode or electrode array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70010","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE1","description":"ICD-OLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC1","description":"ICD-BGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB0","description":"ICD-EFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33710","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63001","description":"Remove spine lamina 1/2 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF1","description":"ICD-CAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ rimabotulinumtoxinb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0587","description":"Inj_ rimabotulinumtoxinb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF1","description":"ICD-NCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA1","description":"ICD-FDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC1","description":"ICD-GCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC1","description":"ICD-ADHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap paraesophag hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43281","description":"Lap paraesophag hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0326U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE0","description":"ICD-JEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD0","description":"ICD-GCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee acrylic socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5629","description":"Below knee acrylic socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16030","description":"Dress/debrid p-thick burn l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE0","description":"ICD-OJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD0","description":"ICD-BEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE0","description":"ICD-BBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF1","description":"ICD-BGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC0","description":"ICD-OFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD104","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00539","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","description":"CPT-00539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351U","description":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thrombomodulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85337","description":"Thrombomodulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC0","description":"ICD-LESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE1","description":"ICD-BCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27001","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibiotic not pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8708","description":"Antibiotic not pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1494","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","description":"HCPCS-M1494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr any 30.1-60 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14301","description":"Tis trnfr any 30.1-60 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA1","description":"ICD-OCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC1","description":"ICD-JHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA0","description":"ICD-FAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unskilled respite care /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5150","description":"Unskilled respite care /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF1","description":"ICD-KIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE0","description":"ICD-KBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC1","description":"ICD-AGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD0","description":"ICD-CETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF1","description":"ICD-GFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB1","description":"ICD-NLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE0","description":"ICD-AEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD1","description":"ICD-OIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33840","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF0","description":"ICD-FIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glucarpidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9293","description":"Injection_ glucarpidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8E","description":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB31","description":"ICD-2KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB1","description":"ICD-JGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB0","description":"ICD-IDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cymetra injectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4112","description":"Cymetra injectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF1","description":"ICD-AIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB211","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nos flu vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2039","description":"Nos flu vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE1","description":"ICD-BDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0902T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","description":"CPT-0902T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC0","description":"ICD-KIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct compd maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7720","description":"Clsd reduct compd maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0917T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","description":"CPT-0917T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust finger ext/flex devc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1825","description":"Adjust finger ext/flex devc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reeva FT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4314","description":"Reeva FT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33510","description":"Cabg vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA0","description":"ICD-PIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA0","description":"ICD-OBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/transpose nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64856","description":"Repair/transpose nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD0","description":"ICD-GBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Systemic antimicrobials not prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9959","description":"Systemic antimicrobials not prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8C","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41140","description":"Removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnioamp-mp_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4250","description":"Amnioamp-mp_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0146","description":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD1","description":"ICD-NKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33010","description":"Drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0721T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35304","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC1","description":"ICD-FHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC11","description":"ICD-3JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD1","description":"ICD-NJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65150","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF0","description":"ICD-MFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC0","description":"ICD-FEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1493","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","description":"HCPCS-M1493","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77076","description":"X-rays bone survey infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ammonia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82140","description":"Assay of ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF1","description":"ICD-OCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF0","description":"ICD-HHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF0","description":"ICD-CCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE0","description":"ICD-OFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA44","description":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF0","description":"ICD-OESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate speech production","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92522","description":"Evaluate speech production","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML54","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC0","description":"ICD-OGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD0","description":"ICD-GECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9187","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9187","description":"HCPCS-J9187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE0","description":"ICD-BCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of thigh brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20663","description":"Application of thigh brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD0","description":"ICD-NKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96103","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB0","description":"ICD-EHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX30","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF0","description":"ICD-GBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv adduct vocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2341","description":"Chemodenerv adduct vocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assessment for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5010","description":"Assessment for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA0","description":"ICD-GIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME1","description":"ICD-KBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB1","description":"ICD-NFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0602","description":"HCPCS-B0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD0","description":"ICD-GADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA21","description":"ICD-4EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC0","description":"ICD-ECCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB0","description":"ICD-EAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC0","description":"ICD-OFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB0","description":"ICD-MHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interro eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418T","description":"Interro eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD1","description":"ICD-FHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8701","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA0","description":"ICD-OHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD130","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE1","description":"ICD-AEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8H","description":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE1","description":"ICD-ADAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9699","description":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC0","description":"ICD-AAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24160","description":"Remove elbow joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF1","description":"ICD-CELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC0","description":"ICD-CBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0016","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC0","description":"ICD-FFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF1","description":"ICD-OEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0467","description":"Fqhc visit_ estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF1","description":"ICD-BFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF0","description":"ICD-CBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome study additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88289","description":"Chromosome study additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC0","description":"ICD-FCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD0","description":"ICD-HDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD0","description":"ICD-JIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA1","description":"ICD-IIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE0","description":"ICD-EGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD1","description":"ICD-KCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF1","description":"ICD-BGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB101","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA0","description":"ICD-NHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dil macula/fundus exam/w doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8397","description":"Dil macula/fundus exam/w doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD1","description":"ICD-KDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB1","description":"ICD-HIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA1","description":"ICD-JFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB0","description":"ICD-JETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC03","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC21","description":"ICD-3LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC1","description":"ICD-MIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD1","description":"ICD-PCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93571","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE0","description":"ICD-KGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD1","description":"ICD-BGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE1","description":"ICD-OEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA11","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF0","description":"ICD-OLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0651T","description":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB1","description":"ICD-OKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA250","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA1","description":"ICD-FHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB1","description":"ICD-JHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig osteo screen measu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8401","description":"Pt inelig osteo screen measu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB1","description":"ICD-JAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC1","description":"ICD-BIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50385","description":"Change stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7538","description":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1043T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1043T","description":"CPT-1043T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA0","description":"ICD-OIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE1","description":"ICD-PKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF1","description":"ICD-FBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF1","description":"ICD-CGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA0","description":"ICD-OKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF0","description":"ICD-LEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted case mgmt per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2023","description":"Targeted case mgmt per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF0","description":"ICD-AEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB160","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE0","description":"ICD-KFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA21","description":"ICD-2CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB0","description":"ICD-KGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC0","description":"ICD-JIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv adrenrg inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95922","description":"Autonomic nrv adrenrg inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29425","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC1","description":"ICD-OHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF0","description":"ICD-GILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC0","description":"ICD-PAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF0","description":"ICD-IDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qual card diag prior 12 mons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1460F","description":"Qual card diag prior 12 mons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA1","description":"ICD-OGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA21","description":"ICD-2JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93594","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Desipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6032","description":"Desipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE0","description":"ICD-HFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD0","description":"ICD-LFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pml/raralpha 1 breakpoint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81316","description":"Pml/raralpha 1 breakpoint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA0","description":"ICD-KIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9832","description":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine hydro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0020","description":"Injection_ bupivicaine hydro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27540","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE0","description":"ICD-OEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","description":"CPT-01930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj ganirelix acetat 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0132","description":"Inj ganirelix acetat 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 50-100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88248","description":"Chromosome analysis 50-100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","description":"HCPCS-Q4388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol response panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80415","description":"Estradiol response panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB1","description":"ICD-EEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acp discuss/dscn mkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1123F","description":"Acp discuss/dscn mkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD1","description":"ICD-EIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF0","description":"ICD-NDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA1","description":"ICD-GBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1039F","description":"Intermittent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME1","description":"ICD-JIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265U","description":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair with detacharm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0165","description":"Commode chair with detacharm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE1","description":"ICD-CFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME1","description":"ICD-NEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0783T","description":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD1","description":"ICD-JDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0A","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD0","description":"ICD-GBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE1","description":"ICD-ICBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC105","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB11","description":"ICD-1BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB0","description":"ICD-BAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00352","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","description":"CPT-00352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB1","description":"ICD-GBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473T","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86337","description":"Insulin antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ret dev_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1773","description":"Ret dev_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB1","description":"ICD-JEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA0","description":"ICD-CERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57465","description":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD1","description":"ICD-HDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phlebotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99195","description":"Phlebotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME0","description":"ICD-MFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier liquid per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4369","description":"Skin barrier liquid per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arch supp att to shoe metata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3080","description":"Arch supp att to shoe metata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD1","description":"ICD-BFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0084U","description":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracardiac ecg (ice)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93662","description":"Intracardiac ecg (ice)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE0","description":"ICD-BFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE1","description":"ICD-FIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB1","description":"ICD-MCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB1","description":"ICD-OGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC0","description":"ICD-GFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD0","description":"ICD-CBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58570","description":"Tlh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE0","description":"ICD-BEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8020","description":"Mastectomy form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54435","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 3-4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73522","description":"X-ray exam hips bi 3-4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace quadlat socket brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4020","description":"Replace quadlat socket brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23462","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1B","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD1","description":"ICD-NKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orchiectomy partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54522","description":"Orchiectomy partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0501","description":"HCPCS-A0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2384","description":"Pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iliac bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20956","description":"Iliac bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD0","description":"ICD-GATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Er+ or pr+ breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3315F","description":"Er+ or pr+ breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF0","description":"ICD-JDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC0","description":"ICD-IFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43122","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD1","description":"ICD-CALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0607U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","description":"CPT-0607U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not disch home day#2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8833","description":"Pt not disch home day#2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB1","description":"ICD-JFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60225","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lift assist for elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6635","description":"Lift assist for elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90624","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","description":"CPT-90624","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE1","description":"ICD-NEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD0","description":"ICD-FAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix non-recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7193","description":"Factor ix non-recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Type location activityassess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1052F","description":"Type location activityassess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs linear based","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77372","description":"Srs linear based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC1","description":"ICD-AIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44800","description":"Excision of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47561","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC236","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA1","description":"ICD-NFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nondisposable pump canister","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7001","description":"Nondisposable pump canister","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE0","description":"ICD-OAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA0","description":"ICD-OCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symptom mgmnt plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555F","description":"Symptom mgmnt plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7526","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE0","description":"ICD-CDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC1","description":"ICD-KIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27788","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE0","description":"ICD-NGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group psychotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90853","description":"Group psychotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25929","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43622","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA1","description":"ICD-PLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans care mgmt 14 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99495","description":"Trans care mgmt 14 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF1","description":"ICD-GDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE0","description":"ICD-CHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB0","description":"ICD-JEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB1","description":"ICD-LFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC0","description":"ICD-CEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","description":"HCPCS-L6039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad intra w/bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33983","description":"Replace vad intra w/bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14060","description":"Tis trnfr e/n/e/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC0","description":"ICD-PFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE1","description":"ICD-CDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC1","description":"ICD-AAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","description":"HCPCS-M1388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB0","description":"ICD-OIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE1","description":"ICD-GCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB1","description":"ICD-AFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID0","description":"ICD-AGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE0","description":"ICD-PHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA0","description":"ICD-BAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD0","description":"ICD-CGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA1","description":"ICD-MEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC1","description":"ICD-EIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX33","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB0","description":"ICD-NIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB1","description":"ICD-OHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq device breast 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19281","description":"Perq device breast 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD0","description":"ICD-GDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF1","description":"ICD-HASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Face tent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4619","description":"Face tent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD0","description":"ICD-CEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA0","description":"ICD-FBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95711","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy clamp_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4363","description":"Ostomy clamp_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Daptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0878","description":"Daptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA111","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB1","description":"ICD-CBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE1","description":"ICD-GCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC0","description":"ICD-JCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ck (cpk)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82550","description":"Assay of ck (cpk)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0822T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","description":"CPT-00810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD0","description":"ICD-GAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE0","description":"ICD-IAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB1","description":"ICD-JDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB1","description":"ICD-KCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC0","description":"ICD-ABTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD1","description":"ICD-LAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD0","description":"ICD-JBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3C","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA0","description":"ICD-OHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0547T","description":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC0","description":"ICD-FBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief alcohol misuse counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0443","description":"Brief alcohol misuse counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76810","description":"Ob us >/= 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE0","description":"ICD-BBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA52","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE0","description":"ICD-KIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33519","description":"Cabg artery-vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Megestrol 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0179","description":"Megestrol 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing systemic antimicrobials","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9960","description":"Documentation of medical reason(s) for prescribing systemic antimicrobials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB0","description":"ICD-KHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27096","description":"Inject sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB1","description":"ICD-OCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD1","description":"ICD-NIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB21","description":"ICD-2BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67923","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hern repair comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49655","description":"Lap inc hern repair comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9068","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tensix_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4146","description":"Tensix_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1002","description":"Custom item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43227","description":"Esophagoscopy control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81292","description":"Mlh1 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB0","description":"ICD-OJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD0","description":"ICD-OLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78481","description":"Heart first pass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF0","description":"ICD-FHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6008","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo community","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9152","description":"Mapcp demo community","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47715","description":"Excision of bile duct cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC1","description":"ICD-NHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50575","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF1","description":"ICD-GCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office visit after hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9440","description":"Office visit after hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF1","description":"ICD-ODAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft hepatorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35535","description":"Art byp grft hepatorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81174","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50392","description":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC234","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44382","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual audiometry (vra)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92579","description":"Visual audiometry (vra)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA0","description":"ICD-LCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF0","description":"ICD-NLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE1","description":"ICD-NLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso flexion control custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0634","description":"Lso flexion control custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL44","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66984","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens extended wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2513","description":"Contact lens extended wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0613","description":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surv score no improv w/tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9605","description":"Surv score no improv w/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9376","description":"Hit hydra 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA1","description":"ICD-GCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00600","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","description":"CPT-00600","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB1","description":"ICD-FFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9304","description":"HCPCS-C9304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29837","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Current cig smoker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9642","description":"Current cig smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 2/> lobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31661","description":"Bronch thermoplsty 2/> lobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA16","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC1","description":"ICD-BAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD0","description":"ICD-OFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC1","description":"ICD-NEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93533","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fabric wrapping of aneurysm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0301","description":"Fabric wrapping of aneurysm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC1","description":"ICD-EEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA0","description":"ICD-MLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9229","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE0","description":"ICD-KDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24006","description":"Release elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31805","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC1","description":"ICD-JDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND1","description":"ICD-CGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE0","description":"ICD-ICBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","description":"HCPCS-M1479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE1","description":"ICD-CISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82248","description":"Bilirubin direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA1","description":"ICD-MEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA0","description":"ICD-JHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67911","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","description":"CPT-15014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE0","description":"ICD-NITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66030","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58200","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are breastfeeding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9779","description":"Patients who are breastfeeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrst mold sock w/exp interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6055","description":"Wrst mold sock w/exp interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB0","description":"ICD-MKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of a-v fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37607","description":"Ligation of a-v fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0756T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA0","description":"ICD-NDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE1","description":"ICD-KEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","description":"CPT-55882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE0","description":"ICD-KHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF0","description":"ICD-DFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB1","description":"ICD-EAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF0","description":"ICD-CAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE0","description":"ICD-PLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9985","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC0","description":"ICD-FIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB0","description":"ICD-NHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB0","description":"ICD-FFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE206","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wet-dry dressings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4265F","description":"Wet-dry dressings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69950","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC0","description":"ICD-KFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB1","description":"ICD-JIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB1","description":"ICD-GCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID1","description":"ICD-FIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"4vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90649","description":"4vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Batt pack/cart_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1356","description":"Batt pack/cart_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF0","description":"ICD-KAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61563","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE1","description":"ICD-MCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB1","description":"ICD-MGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9191","description":"Pt reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB0","description":"ICD-CIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD0","description":"ICD-OCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF0","description":"ICD-HDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF1","description":"ICD-AFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC0","description":"ICD-KGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD1","description":"ICD-EGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2797","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID1","description":"ICD-EFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF1","description":"ICD-GFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA0","description":"ICD-OFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE1","description":"ICD-DBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA1","description":"ICD-CIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF0","description":"ICD-MCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl semi/precision attach","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6091","description":"Repl semi/precision attach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF0","description":"ICD-FIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD1","description":"ICD-PAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc funct and care plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8539","description":"Doc funct and care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray female genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74740","description":"X-ray female genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA0","description":"ICD-IALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25023","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE0","description":"ICD-OKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB0","description":"ICD-ADAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA1","description":"ICD-JDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dm meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8494","description":"Dm meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC0","description":"ICD-ACEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28675","description":"Repair of toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA30","description":"Ultra High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB0","description":"ICD-CEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA1","description":"ICD-KFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal shunt placement w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59076","description":"Fetal shunt placement w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD1","description":"ICD-AATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Static or dynami afo pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4396","description":"Static or dynami afo pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC1","description":"ICD-NFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00700","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","description":"CPT-00700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA0","description":"ICD-OIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA1","description":"ICD-JHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0792T","description":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF0","description":"ICD-OBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test sock wrist disart/bel e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6680","description":"Test sock wrist disart/bel e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF1","description":"ICD-CGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB1","description":"ICD-OFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23044","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB0","description":"ICD-KFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01963","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","description":"CPT-01963","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA0","description":"ICD-DDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1189","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF0","description":"ICD-BHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC1","description":"ICD-JFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA0","description":"ICD-GDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF0","description":"ICD-LGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skin wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15829","description":"Removal of skin wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE0","description":"ICD-IBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF0","description":"ICD-EIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ siltuximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2860","description":"Injection_ siltuximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28575","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68505","description":"Partial removal tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11982","description":"Remove drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA1","description":"ICD-IGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrigation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4398","description":"Ostomy irrigation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF0","description":"ICD-FEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF0","description":"ICD-FCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE1","description":"ICD-OGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB1","description":"ICD-OJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235U","description":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD1","description":"ICD-BDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0801","description":"HCPCS-C0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suture bile duct injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47900","description":"Suture bile duct injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA1","description":"ICD-ECHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33475","description":"Replacement pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no compl antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9300","description":"Doc medrsn no compl antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC1","description":"ICD-IADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA0","description":"ICD-ACUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enclosed walker w rear seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0144","description":"Enclosed walker w rear seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9368","description":"2high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xylose tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84620","description":"Xylose tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB0","description":"ICD-FGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF1","description":"ICD-MLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelet survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78190","description":"Platelet survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA1","description":"ICD-GAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD1","description":"ICD-NHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alprostadil urethral suppos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0275","description":"Alprostadil urethral suppos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4D","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238U","description":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF1","description":"ICD-NEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC0","description":"ICD-BHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC1","description":"ICD-IBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrocochleography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92584","description":"Electrocochleography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72148","description":"MRI lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam knee 4 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73564","description":"X-ray exam knee 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF1","description":"ICD-CCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brst cncr stage > t1n0m0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8881","description":"Brst cncr stage > t1n0m0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE0","description":"ICD-EDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB0","description":"ICD-PARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC1","description":"ICD-GCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC1","description":"ICD-NBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent placemt ante carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37218","description":"Stent placemt ante carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44370","description":"Small bowel endoscopy/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9031","description":"Platelets leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61580","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF0","description":"ICD-ECUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58600","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking garter belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6544","description":"Gc stocking garter belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1115","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF1","description":"ICD-CHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0607","description":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB1","description":"ICD-FACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9255","description":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB1","description":"ICD-MICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB0","description":"ICD-NKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9291","description":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC0","description":"ICD-NALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27658","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove intra-aortic balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33974","description":"Remove intra-aortic balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC1","description":"ICD-IAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ automated sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0147","description":"Scr c/v cyto_ automated sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF0","description":"ICD-ODAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22632","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF1","description":"ICD-AADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC1","description":"ICD-BDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0527T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5952","description":"Pediatric speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26580","description":"Repair hand deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52007","description":"Cystoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31400","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC0","description":"ICD-MGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6238","description":"Hydrocolld drg >16<=48 w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of neck/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21550","description":"Biopsy of neck/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flt3 gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81246","description":"Flt3 gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80402","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC0","description":"ICD-NLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92285","description":"Eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA1","description":"ICD-CHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69662","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA1","description":"ICD-NELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD1","description":"ICD-MBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36837","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9129","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9129","description":"CDT-D9129","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353U","description":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0526U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","description":"CPT-0526U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD0","description":"ICD-OJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0678","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0678","description":"HCPCS-G0678","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51880","description":"Repair of bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit mech ventilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99504","description":"Home visit mech ventilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7331","description":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25290","description":"Incise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stomach surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43999","description":"Stomach surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE0","description":"ICD-CEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval aud status rehab add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92627","description":"Eval aud status rehab add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB0","description":"ICD-FEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attendant control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2331","description":"Attendant control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD1","description":"ICD-BHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3630","description":"Trans shoe solid stirrup new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Agriflu vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2034","description":"Agriflu vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF0","description":"ICD-CCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX25","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD251","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7461","description":"Rem nonodonto cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA11","description":"ICD-4HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9052","description":"Injection_ ravulizumab-cwvz_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11101","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD0","description":"ICD-OIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE0","description":"ICD-FIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF0","description":"ICD-NLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF0","description":"ICD-JHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD0","description":"ICD-OJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF0","description":"ICD-NAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC136","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1119F","description":"Init eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF1","description":"ICD-MEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA1","description":"ICD-BDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA0","description":"ICD-DIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE0","description":"ICD-KDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE0","description":"ICD-FEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF1","description":"ICD-CCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3A","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA230","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE0","description":"ICD-FCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clean rem part denture max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9934","description":"Clean rem part denture max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB0","description":"ICD-OKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE1","description":"ICD-GGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Integra meshed bil wound mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9363","description":"Integra meshed bil wound mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF0","description":"ICD-GCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF0","description":"ICD-GBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE1","description":"ICD-DCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB1","description":"ICD-MLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1013T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","description":"CPT-1013T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermal filler injection(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0429","description":"Dermal filler injection(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC1","description":"ICD-JCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC1","description":"ICD-OFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF1","description":"ICD-NCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Support broker waiver/15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2041","description":"Support broker waiver/15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain arm/elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23935","description":"Drain arm/elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA1","description":"ICD-FIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep a vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4148F","description":"Hep a vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF0","description":"ICD-OFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26352","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90945","description":"Dialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC0","description":"ICD-EDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB1","description":"ICD-BFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood methemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83045","description":"Blood methemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt preterm labor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9208","description":"Home mgmt preterm labor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA1","description":"ICD-HHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA0","description":"ICD-MEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB0","description":"ICD-NJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Female condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4268","description":"Female condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC1","description":"ICD-NLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53620","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75801","description":"Lymph vessel x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreas surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48999","description":"Pancreas surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL23","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC0","description":"ICD-BACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87651","description":"Strep a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99374","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB1","description":"ICD-GCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73615","description":"Contrast x-ray of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF0","description":"ICD-KDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC0","description":"ICD-JCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA0","description":"ICD-NLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd cautery tumor polyp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43250","description":"Egd cautery tumor polyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD0","description":"ICD-CCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE0","description":"ICD-HEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML33","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"F emb trns canc case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4018","description":"F emb trns canc case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX60","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA1","description":"ICD-JHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA34","description":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic shoe modifica nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3649","description":"Orthopedic shoe modifica nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99415","description":"Prolong clincl staff svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26843","description":"Fusion of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472U","description":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shdr fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6588","description":"Shdr fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22101","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF0","description":"ICD-PEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB0","description":"ICD-CHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct extra finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26587","description":"Reconstruct extra finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leflunomide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80193","description":"Leflunomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC0","description":"ICD-OKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indic for head ct not valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9533","description":"Indic for head ct not valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB1","description":"ICD-OBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA1","description":"ICD-MFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC0","description":"ICD-MADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Idursulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1743","description":"Idursulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methacholine chloride_ neb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7674","description":"Methacholine chloride_ neb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB0","description":"ICD-EBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB0","description":"ICD-DFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA0","description":"ICD-FAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB17","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB0","description":"ICD-CHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA210","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE1","description":"ICD-NHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9911","description":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of nasal bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70160","description":"X-ray exam of nasal bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15221","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB1","description":"ICD-KFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33612","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical revision intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44680","description":"Surgical revision intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA0","description":"ICD-MEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert plastazote or eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3002","description":"Foot insert plastazote or eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA1","description":"ICD-ODGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE0","description":"ICD-CATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corticotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0800","description":"Corticotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF0","description":"ICD-IAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC1","description":"ICD-OGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF1","description":"ICD-KFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-molded lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2320","description":"Non-molded lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC0","description":"ICD-GCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF0","description":"ICD-JIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME1","description":"ICD-KFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF1","description":"ICD-GHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time activated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85347","description":"Coagulation time activated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB1","description":"ICD-EATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF1","description":"ICD-HDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB1","description":"ICD-NDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA0","description":"ICD-KBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD1","description":"ICD-AHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF0","description":"ICD-GCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC0","description":"ICD-KEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34111","description":"Removal of arm artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1448","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","description":"HCPCS-M1448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA0","description":"ICD-FDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84078","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61697","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0C","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1180","description":"Wheelchair amputee w/ foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB1","description":"ICD-IFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC1","description":"ICD-IGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gravlee jet washer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4470","description":"Gravlee jet washer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frenulectomy/frenulotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7960","description":"Frenulectomy/frenulotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF0","description":"ICD-DCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31298","description":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart pacing mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93631","description":"Heart pacing mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD0","description":"ICD-JDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385U","description":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0648U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0648U","description":"CPT-0648U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE1","description":"ICD-LCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC1","description":"ICD-CCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA0","description":"ICD-MDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ inflatab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1813","description":"Prosthesis_ penile_ inflatab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glycated protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82985","description":"Assay of glycated protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special service/proc/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99199","description":"Special service/proc/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE0","description":"ICD-DDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tenolysis triceps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24332","description":"Tenolysis triceps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0592","description":"Hospital Special Treatment Room Support Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28415","description":"Treat heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF0","description":"ICD-OJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB0","description":"ICD-FDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF1","description":"ICD-CAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5115","description":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD0","description":"ICD-BIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev cardrehab qualcardevent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4510F","description":"Prev cardrehab qualcardevent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD1","description":"ICD-OFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8E","description":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0629U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","description":"CPT-0629U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID1","description":"ICD-OJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE0","description":"ICD-BHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD0","description":"ICD-NFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE0","description":"ICD-OIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA0","description":"ICD-JHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB31","description":"ICD-2CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD1","description":"ICD-GCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC1","description":"ICD-DAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD1","description":"ICD-CBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Card tamp w/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9408","description":"Card tamp w/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA0","description":"ICD-PLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF1","description":"ICD-NBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA0","description":"ICD-JAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC0","description":"ICD-FFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0025","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF0","description":"ICD-HIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD1","description":"ICD-GESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB0","description":"ICD-KHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD0","description":"ICD-CIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topical anesthetic_ per gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4736","description":"Topical anesthetic_ per gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44186","description":"Lap jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES225","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vacuum drain bottle/tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7048","description":"Vacuum drain bottle/tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA1","description":"ICD-NKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF1","description":"ICD-AEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC1","description":"ICD-CFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE1","description":"ICD-CDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA1","description":"ICD-JBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC0","description":"ICD-OILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC0","description":"ICD-NJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA1","description":"ICD-CAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB0","description":"ICD-JBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert epicard eltrd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33203","description":"Insert epicard eltrd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9570","description":"Indium in-111 auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA0","description":"ICD-MGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical foods for inborn err","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9435","description":"Medical foods for inborn err","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cpk in blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82552","description":"Assay of cpk in blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB1","description":"ICD-AEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA0","description":"ICD-CILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmv antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86644","description":"Cmv antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF0","description":"ICD-CDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of halo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20664","description":"Application of halo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB1","description":"ICD-KEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF1","description":"ICD-NDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5123","description":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology hrt trnspl mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81595","description":"Cardiology hrt trnspl mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE1","description":"ICD-JABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA1","description":"ICD-EFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC0","description":"ICD-BELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD0","description":"ICD-EFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC0","description":"ICD-KAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No smok b/4 anes day of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9644","description":"No smok b/4 anes day of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3280","description":"Thiethylperazine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27832","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Should sling/vest/abrestrain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4566","description":"Should sling/vest/abrestrain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA0","description":"ICD-CHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove int/ext hem 1 group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46255","description":"Remove int/ext hem 1 group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical Therapy/Occupational Therapy Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4026","description":"Physical Therapy/Occupational Therapy Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB0","description":"ICD-FGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Etonogestrel implant system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7307","description":"Etonogestrel implant system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED1","description":"ICD-ECED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA0","description":"ICD-NBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pp eval/edu perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9357","description":"Pp eval/edu perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of tibia epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27730","description":"Repair of tibia epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD0","description":"ICD-IIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE1","description":"ICD-KGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7649","description":"Isoetharine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28725","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect diaphragm complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39561","description":"Resect diaphragm complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4278","description":"Soft tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1/hiv-2 1 result antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86703","description":"Hiv-1/hiv-2 1 result antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90832","description":"Psytx pt&/family 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj vnt elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411T","description":"Insj/rplc car modulj vnt elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech Language Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4034","description":"Speech Language Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - patient education to improve oral health literacy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9994","description":"Dental case management - patient education to improve oral health literacy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate crtd sns w/pgrmg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273T","description":"Interrogate crtd sns w/pgrmg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dt vaccine under 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90702","description":"Dt vaccine under 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ intraspinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1755","description":"Catheter_ intraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93321","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA15","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc biliary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47579","description":"Laparoscope proc biliary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deluxe item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1001","description":"Deluxe item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78483","description":"Heart first pass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject for lymphatic x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38790","description":"Inject for lymphatic x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC1","description":"ICD-LGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA1","description":"ICD-GAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sheath below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8400","description":"Sheath below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE1","description":"ICD-CILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37700","description":"Revise leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub grft t/arm/lg child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15273","description":"Skin sub grft t/arm/lg child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain w/ noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2752","description":"Crown porcelain w/ noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC1","description":"ICD-NBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of floor of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41108","description":"Biopsy of floor of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9999","description":"HCPCS-A9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF0","description":"ICD-KHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clonidine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0735","description":"Clonidine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE1","description":"ICD-HGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2398","description":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4049F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth >=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2602","description":"Gen w/c cushion wdth >=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50900","description":"Repair of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Copd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8757","description":"Copd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx oral admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79005","description":"Nuclear rx oral admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bezlotoxumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0565","description":"Injection_ bezlotoxumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC0","description":"ICD-IBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD1","description":"ICD-OFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA31","description":"ICD-1GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94762","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE0","description":"ICD-MHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB1","description":"ICD-JHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA26","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC0","description":"ICD-NJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC1","description":"ICD-KHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA31","description":"ICD-1CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58940","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME1","description":"ICD-FEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE0","description":"ICD-FBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SYPHILIS TST ANTB IA QUAN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210U","description":"SYPHILIS TST ANTB IA QUAN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33665","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF0","description":"ICD-GFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA1","description":"ICD-MLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA1","description":"ICD-FFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening tests dm done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3754F","description":"Screening tests dm done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF1","description":"ICD-DDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22554","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF1","description":"ICD-KGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt drug device for iop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356T","description":"Insrt drug device for iop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46045","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shunt accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4740","description":"Shunt accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE0","description":"ICD-OFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture belly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35122","description":"Repair artery rupture belly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA0","description":"ICD-EHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB0","description":"ICD-FFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF1","description":"ICD-KIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC0","description":"ICD-NFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL34","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE1","description":"ICD-GIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA0","description":"ICD-DFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE1","description":"ICD-CDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hard protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8001","description":"Hard protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61150","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB1","description":"ICD-NEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB1","description":"ICD-BBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB0","description":"ICD-NJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB0","description":"ICD-OBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco non-user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1036F","description":"Tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49500","description":"Rpr ing hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25695","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB1","description":"ICD-FFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brow nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64732","description":"Incision of brow nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of inf vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37619","description":"Ligation of inf vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB0","description":"ICD-MJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE0","description":"ICD-ICHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice or home hlth in home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5001","description":"Hospice or home hlth in home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3386F","description":"Ajcc cln cncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA1","description":"ICD-OAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB1","description":"ICD-JFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA1","description":"ICD-KGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Consult inc prep of slides","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0485","description":"Consult inc prep of slides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF1","description":"ICD-NKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF1","description":"ICD-OJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna antibody native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86225","description":"Dna antibody native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0402","description":"CDT-D0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD1","description":"ICD-LHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laa closure w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281T","description":"Laa closure w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB1","description":"ICD-BHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF1","description":"ICD-JIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradation quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85379","description":"Fibrin degradation quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt falls assess-docd le1/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1101F","description":"Pt falls assess-docd le1/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water distilled w/nebulizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7018","description":"Water distilled w/nebulizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB1","description":"ICD-CAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0960T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","description":"CPT-0960T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD0","description":"ICD-HGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC0","description":"ICD-BBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF1","description":"ICD-BCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB0","description":"ICD-AEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF1","description":"ICD-NLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID1","description":"ICD-MFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378U","description":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD1","description":"ICD-JHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC1","description":"ICD-GAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy shower protect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7523","description":"Tracheostomy shower protect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc back tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21933","description":"Exc back tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC0","description":"ICD-OICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4195","description":"PuraPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface above knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2830","description":"Soft interface above knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33966","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD0","description":"ICD-NAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC1","description":"ICD-MDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt neurostim elctr each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8680","description":"Implt neurostim elctr each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD1","description":"ICD-GIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF1","description":"ICD-NIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9416","description":"Tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB21","description":"ICD-4EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF0","description":"ICD-MGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1018","description":"Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma)_ patients who are h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC31","description":"ICD-3KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC31","description":"ICD-4JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25263","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE1","description":"ICD-IBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of nephrostomy or pyelostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50398","description":"Change of nephrostomy or pyelostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF1","description":"ICD-MFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ bal tis dis_ non-vas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1727","description":"Cath_ bal tis dis_ non-vas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA1","description":"ICD-EGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE1","description":"ICD-GBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD1","description":"ICD-GGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgicord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4218","description":"Surgicord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC1","description":"ICD-FHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27238","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE1","description":"ICD-FHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB1","description":"ICD-KHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC0","description":"ICD-AHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8B","description":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF1","description":"ICD-MCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD1","description":"ICD-JFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF1","description":"ICD-KCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","description":"HCPCS-L6028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC1","description":"ICD-FAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD0","description":"ICD-FFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF1","description":"ICD-FDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61557","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual standing system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2230","description":"Manual standing system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX13","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA1","description":"ICD-JFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC0","description":"ICD-FIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate sz 14 day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382T","description":"Ext h rate sz 14 day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC1","description":"ICD-PKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 6/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72084","description":"X-ray exam entire spi 6/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD0","description":"ICD-PGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD0","description":"ICD-OKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug delivery system >=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4305","description":"Drug delivery system >=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE0","description":"ICD-PIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9589","description":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD1","description":"ICD-JDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"WoundPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4326","description":"WoundPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8815","description":"Doc reas no statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB1","description":"ICD-GBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate lower leg at knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27598","description":"Amputate lower leg at knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE0","description":"ICD-NJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF0","description":"ICD-AEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC0","description":"ICD-OHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5121","description":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bedside drainage bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4357","description":"Bedside drainage bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED0","description":"ICD-EEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC1","description":"ICD-NEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE1","description":"ICD-JBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87798","description":"Detect agent nos dna amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9735","description":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB0","description":"ICD-JHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF0","description":"ICD-NJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB1","description":"ICD-DFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt has resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1504F","description":"Pt has resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB0","description":"ICD-BDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF0","description":"ICD-KCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE1","description":"ICD-KDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB0","description":"ICD-IAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/fhdw/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21159","description":"Lefort iii w/fhdw/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Omental flap intra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49905","description":"Omental flap intra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I & d vaginal hematoma pp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57022","description":"I & d vaginal hematoma pp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA0","description":"ICD-NGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of idh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83570","description":"Assay of idh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB0","description":"ICD-FFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15135","description":"Derm autograft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF0","description":"ICD-ECMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0899T","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB36","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0481U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","description":"CPT-0481U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2001","description":"HCPCS-B2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA1","description":"ICD-KFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB1","description":"ICD-OJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF1","description":"ICD-CCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC1","description":"ICD-NFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1980","description":"Afo sing solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD1","description":"ICD-NHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82044","description":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB1","description":"ICD-OLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High activity knee frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5930","description":"High activity knee frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF0","description":"ICD-CIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF0","description":"ICD-CDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92933","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB0","description":"ICD-DHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA1","description":"ICD-FFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tooth pin retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2951","description":"Tooth pin retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD0","description":"ICD-NJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD1","description":"ICD-GEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED1","description":"ICD-IDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic rem appliance tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8210","description":"Orthodontic rem appliance tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD0","description":"ICD-CGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE1","description":"ICD-LDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB1","description":"ICD-FAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC1","description":"ICD-BBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So hard plas stabili pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3678","description":"So hard plas stabili pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9267","description":"Doc comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC1","description":"ICD-CEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vasopneumatic device therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97016","description":"Vasopneumatic device therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF1","description":"ICD-FEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA1","description":"ICD-KBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In111 capromab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9507","description":"In111 capromab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND1","description":"ICD-BHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD1","description":"ICD-JHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB0","description":"ICD-OHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC0","description":"ICD-EADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9324","description":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES312","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC0","description":"ICD-OFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2634","description":"Brachytx_ non-str_ ha_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4527","description":"Adult size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj all parts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43774","description":"Lap rmvl gastr adj all parts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tah rad debulk/lymph remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58954","description":"Tah rad debulk/lymph remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD146","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD0","description":"ICD-NIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE1","description":"ICD-CIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5818","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA1","description":"ICD-OIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA0","description":"ICD-BACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD0","description":"ICD-GBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD0","description":"ICD-BEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE1","description":"ICD-NIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB213","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50825","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10008","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB0","description":"ICD-PHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE1","description":"ICD-FFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor lung single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32855","description":"Prepare donor lung single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast milk proc/store/dist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2101","description":"Breast milk proc/store/dist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8B","description":"Low Rehab_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF1","description":"ICD-PEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Membrane wrap-hydro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4290","description":"Membrane wrap-hydro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA1","description":"ICD-NKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC1","description":"ICD-AACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA0","description":"ICD-NLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0D","description":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE1","description":"ICD-CHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD1","description":"ICD-PGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD0","description":"ICD-IDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA1","description":"ICD-OASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25151","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93572","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1957","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1957","description":"HCPCS-J1957","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE1","description":"ICD-EFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB1","description":"ICD-ACEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibiot rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4120F","description":"Antibiot rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5946","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5946","description":"CDT-D5946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC0","description":"ICD-MKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB1","description":"ICD-CGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag w/us_ ct or MRI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9455","description":"Abd imag w/us_ ct or MRI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC0","description":"ICD-OIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44372","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0388","description":"intraoral tomosynthesis - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relieve bladder contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52640","description":"Relieve bladder contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD1","description":"ICD-MHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA0","description":"ICD-GHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF0","description":"ICD-DGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE1","description":"ICD-BBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID0","description":"ICD-AFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5099","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","description":"HCPCS-Q5099","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81529","description":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71250","description":"Ct thorax w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB0","description":"ICD-MIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE0","description":"ICD-OHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abl1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81170","description":"Abl1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD1","description":"ICD-OJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD1","description":"ICD-MALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF0","description":"ICD-NEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB0","description":"ICD-PIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB1","description":"ICD-PJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE1","description":"ICD-NEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF1","description":"ICD-HAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD0","description":"ICD-AEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD1","description":"ICD-CBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg2 no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9064","description":"Onc dx nsclc stg2 no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62380","description":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0961T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","description":"CPT-0961T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC0","description":"ICD-HHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB0","description":"ICD-IIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE1","description":"ICD-GHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: positional headaches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2191","description":"Patients with clinical indications for imaging of the head: positional headaches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD1","description":"ICD-CCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE1","description":"ICD-BGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix recombinan rixubis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7200","description":"Factor ix recombinan rixubis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 25MCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91311","description":"SARSCOV2 VAC 25MCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","description":"HCPCS-M1392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81536","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF0","description":"ICD-HDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX26","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB0","description":"ICD-KHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA16","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC1","description":"ICD-JIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mdd moderate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3089F","description":"Mdd moderate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card angio/athrect 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92924","description":"Prq card angio/athrect 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC0","description":"ICD-CCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt surv results not avail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9604","description":"Pt surv results not avail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE1","description":"ICD-NALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE1","description":"ICD-BFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6370","description":"Thoracic passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB16","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF1","description":"ICD-JIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF0","description":"ICD-DIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF0","description":"ICD-NAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC0","description":"ICD-KFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA1","description":"ICD-CFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC1","description":"ICD-NDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF1","description":"ICD-OJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aldosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82088","description":"Assay of aldosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA1","description":"ICD-MFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31575","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1403","description":"CDT-D1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Panitumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9303","description":"Panitumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES245","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA21","description":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF1","description":"ICD-BAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA0","description":"ICD-JDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF0","description":"ICD-KFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF0","description":"ICD-NHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED0","description":"ICD-MHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB0","description":"ICD-JBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF1","description":"ICD-CIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD1","description":"ICD-HGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24615","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88374","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5B","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB0","description":"ICD-BDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB0","description":"ICD-BHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE0","description":"ICD-KECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA0","description":"ICD-PHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE1","description":"ICD-GCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2B","description":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA0","description":"ICD-JBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE0","description":"ICD-OGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate pulm tumors extnsn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340T","description":"Ablate pulm tumors extnsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE1","description":"ICD-HFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF0","description":"ICD-BCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB1","description":"ICD-GBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5262","description":"Hearing aid_ disp_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hypnotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90880","description":"Hypnotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF1","description":"ICD-OENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC0","description":"ICD-BITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD0","description":"ICD-OIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB0","description":"ICD-AEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreserve testicular tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89335","description":"Cryopreserve testicular tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD1","description":"ICD-GAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE0","description":"ICD-OJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65175","description":"Removal of ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC0","description":"ICD-HBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52240","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF0","description":"ICD-GIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml acceler phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9124","description":"Onc dx cml acceler phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF0","description":"ICD-BETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED1","description":"ICD-CIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA1","description":"ICD-JAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv col sr foam 2pc pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0172","description":"Cerv col sr foam 2pc pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2106","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF1","description":"ICD-MELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB1","description":"ICD-CCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair corporeal tear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54437","description":"Repair corporeal tear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC1","description":"ICD-KBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD1","description":"ICD-FHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332U","description":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of iron","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83540","description":"Assay of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2113","description":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy resect septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58560","description":"Hysteroscopy resect septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pure tone audiometry air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92552","description":"Pure tone audiometry air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD0","description":"ICD-BAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB0","description":"ICD-NCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49321","description":"Laparoscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE0","description":"ICD-OAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF0","description":"ICD-MLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA1","description":"ICD-MATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF0","description":"ICD-CAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB1","description":"ICD-MLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86940","description":"Hemolysins/agglutinins auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB236","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27177","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelv 1/> regns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74178","description":"Ct abd & pelv 1/> regns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE0","description":"ICD-JBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD0","description":"ICD-BAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA0","description":"ICD-JIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC0","description":"ICD-AALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF0","description":"ICD-HAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC0","description":"ICD-DARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61705","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4048","description":"Cast sup sht leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0063","description":"Cardiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE0","description":"ICD-BGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht care plan doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4050F","description":"Ht care plan doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4A","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6578","description":"Gradient compression arm sleeve_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l5-s1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22586","description":"Prescrl fuse w/ instr l5-s1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE0","description":"ICD-PGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA0","description":"ICD-FFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9637","description":"At least two orders for the same high-risk medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0019","description":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND1","description":"ICD-KIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97130","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA0","description":"ICD-CGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB1","description":"ICD-ODRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE1","description":"ICD-BFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA1","description":"ICD-NLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special casting material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4590","description":"Special casting material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA0","description":"ICD-EBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inactivated je vacc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90738","description":"Inactivated je vacc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1139","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF0","description":"ICD-CHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF1","description":"ICD-CGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC0","description":"ICD-BEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE204","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6529","description":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154U","description":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF0","description":"ICD-MFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID0","description":"ICD-JFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51728","description":"Cystometrogram w/vp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB0","description":"ICD-OJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N-et; stretcher van_ mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2049","description":"N-et; stretcher van_ mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add standard toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3550","description":"O shoe add standard toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB1","description":"ICD-FICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB1","description":"ICD-FBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA1","description":"ICD-KACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA11","description":"ICD-1DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventilating tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69424","description":"Remove ventilating tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF0","description":"ICD-JEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable cycler set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4671","description":"Disposable cycler set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext ureth clmp or compr dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4356","description":"Ext ureth clmp or compr dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL15","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA1","description":"ICD-ABCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD0","description":"ICD-NBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy eyelid & lid margin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67810","description":"Biopsy eyelid & lid margin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE1","description":"ICD-KBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF0","description":"ICD-IHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unskilled respitecare /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5151","description":"Unskilled respitecare /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE0","description":"ICD-CARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD0","description":"ICD-JGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00164","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","description":"CPT-00164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF0","description":"ICD-OAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB0","description":"ICD-OCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC0","description":"ICD-CFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC1","description":"ICD-DFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB0","description":"ICD-IGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE1","description":"ICD-PHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Florbetapir f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9586","description":"Florbetapir f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9372","description":"Ht inj anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE1","description":"ICD-OCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC1","description":"ICD-EICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp5 ped mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0891","description":"Pwc gp5 ped mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q12h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9501","description":"Hit antibiotic q12h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01780","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","description":"CPT-01780","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA0","description":"ICD-IEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA12","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB31","description":"ICD-3FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB1","description":"ICD-KIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA1","description":"ICD-CALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0403","description":"HCPCS-B0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6203","description":"Composite drsg <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE0","description":"ICD-AGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD0","description":"ICD-OKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachy_non-str_ytterbium-169","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2637","description":"Brachy_non-str_ytterbium-169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD0","description":"ICD-OLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2B_ platelet-binding evaluation_ radioimmunoassay_ plasma (Versitiâ„¢ VWD Type 2B Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283U","description":"von Willebrand factor (VWF)_ type 2B_ platelet-binding evaluation_ radioimmunoassay_ plasma (Versitiâ„¢ VWD Type 2B Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49585","description":"Rpr umbil hern reduc > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA0","description":"ICD-CCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB1","description":"ICD-NLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240U","description":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE1","description":"ICD-DHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID0","description":"ICD-FFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil three surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2430","description":"Dental gold foil three surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB1","description":"ICD-GDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE210","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0304","description":"HCPCS-C0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD0","description":"ICD-KDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF0","description":"ICD-MGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection into hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46500","description":"Injection into hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC221","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult day care per half day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5101","description":"Adult day care per half day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME0","description":"ICD-IGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF0","description":"ICD-EHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD1","description":"ICD-OHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB1","description":"ICD-CBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD0","description":"ICD-FAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay urine catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82382","description":"Assay urine catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME1","description":"ICD-CHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exfoliative cytolog collect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7287","description":"Exfoliative cytolog collect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22B","description":"Special Care Low _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE0","description":"ICD-CAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB0","description":"ICD-CGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Als defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0392","description":"Als defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Idarubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9211","description":"Idarubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74182","description":"MRI abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE0","description":"ICD-BFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0685T","description":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC0","description":"ICD-JICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE0","description":"ICD-NKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9370","description":"Ht inj antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD0","description":"ICD-EDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0599U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","description":"CPT-0599U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35460","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB0","description":"ICD-NJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE1","description":"ICD-OJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB1","description":"ICD-OEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF1","description":"ICD-OJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC1","description":"ICD-JFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA0","description":"ICD-IFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND0","description":"ICD-FFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE1","description":"ICD-KFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB0","description":"ICD-HEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal at risk education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1003","description":"Prenatal at risk education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA1","description":"ICD-BEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21138","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC0","description":"ICD-OIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth penis nodes removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93651","description":"Anesth penis nodes removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc w burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8908","description":"Pt doc w burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC0","description":"ICD-AFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC1","description":"ICD-KAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA0","description":"ICD-NCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC0","description":"ICD-KETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast supplies unlisted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4050","description":"Cast supplies unlisted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9116","description":"Onc dx ovarian recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID0","description":"ICD-KAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB21","description":"ICD-4CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm tum deep 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25073","description":"Exc forearm tum deep 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobile arm support supinator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2633","description":"Mobile arm support supinator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81455","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumb artif diskectomy addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163T","description":"Lumb artif diskectomy addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD144","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE0","description":"ICD-OGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0899","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5114","description":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE1","description":"ICD-OBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC0","description":"ICD-JCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97139","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA1","description":"ICD-MFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8I","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA0","description":"ICD-PAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE1","description":"ICD-GCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32482","description":"Bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA1","description":"ICD-PKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA1","description":"ICD-ODJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB1","description":"ICD-ADLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF0","description":"ICD-FCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB0","description":"ICD-JCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice routine home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2042","description":"Hospice routine home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE0","description":"ICD-IEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc sbsq vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37185","description":"Prim art m-thrmbc sbsq vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; parenchyma (eg_ organ)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76981","description":"Ultrasound_ elastography; parenchyma (eg_ organ)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Direct immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0482","description":"Direct immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE0","description":"ICD-ODGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF0","description":"ICD-GIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33995","description":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC1","description":"ICD-GCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD0","description":"ICD-FFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC1","description":"ICD-DGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA45","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF0","description":"ICD-BCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD1","description":"ICD-DDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD1","description":"ICD-CARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44406","description":"Colonoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC1","description":"ICD-FBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam of head and neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76536","description":"Us exam of head and neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain image < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78600","description":"Brain image < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analyze pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93724","description":"Analyze pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD1","description":"ICD-NBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF0","description":"ICD-OEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97162","description":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA0","description":"ICD-NLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90748","description":"Hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 4 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90747","description":"Hepb vacc 4 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-elec oscillatory pep dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0484","description":"Non-elec oscillatory pep dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Odontics repr abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6095","description":"Odontics repr abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0703","description":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1304","description":"HCPCS-A1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA1","description":"ICD-AEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33988","description":"Insertion of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC0","description":"ICD-KFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE0","description":"ICD-CGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD1","description":"ICD-FIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF0","description":"ICD-OHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84100","description":"Assay of phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1242","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE1","description":"ICD-MILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE224","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC225","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID1","description":"ICD-GGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE0","description":"ICD-MLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC1","description":"ICD-FHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD0","description":"ICD-PIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME1","description":"ICD-NJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF1","description":"ICD-NLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC1","description":"ICD-EDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA0","description":"ICD-MBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE1","description":"ICD-NICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB1","description":"ICD-BEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD0","description":"ICD-BAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF1","description":"ICD-JDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF0","description":"ICD-EBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC1","description":"ICD-BENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB11","description":"ICD-3GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tap block bi injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64488","description":"Tap block bi injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung ventilat&perfus imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78582","description":"Lung ventilat&perfus imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trim nail(s) any number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11719","description":"Trim nail(s) any number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA31","description":"ICD-2GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB0","description":"ICD-ODFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA1","description":"ICD-DCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA0","description":"ICD-OFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86850","description":"Rbc antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE1","description":"ICD-OCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB1","description":"ICD-PJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF0","description":"ICD-PCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0190","description":"Screening of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD1","description":"ICD-GDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coa/non-cov w/del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1876","description":"Stent_ non-coa/non-cov w/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6117","description":"Imp/abut fixed dent part man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES356","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA0","description":"ICD-BCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB0","description":"ICD-CFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9932","description":"Clean & inspect rem dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC1","description":"ICD-GEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES240","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2179","description":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA07","description":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8625","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE1","description":"ICD-NEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF0","description":"ICD-IBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0870","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","description":"HCPCS-J0870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41821","description":"Excision of gum flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon beta-1b / .25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1830","description":"Interferon beta-1b / .25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traction frame attach pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0890","description":"Traction frame attach pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC0","description":"ICD-KDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant connecting bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6055","description":"Implant connecting bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC0","description":"ICD-GFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD1","description":"ICD-JDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB1","description":"ICD-HHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC0","description":"ICD-KALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26841","description":"Fusion of thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo tibial fracture soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2112","description":"Afo tibial fracture soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med ind for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9361","description":"Med ind for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","description":"CPT-00740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF1","description":"ICD-AIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF0","description":"ICD-GHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kne sing axis fric shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5200","description":"Kne sing axis fric shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0102","description":"Residential Habilitation 4-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA0","description":"ICD-DBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61519","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4162","description":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD1","description":"ICD-IHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE1","description":"ICD-LHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB1","description":"ICD-NBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB0","description":"ICD-NAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE1","description":"ICD-NLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA0","description":"ICD-KHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB1","description":"ICD-OKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE234","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB1","description":"ICD-EDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA0","description":"ICD-CAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF1","description":"ICD-HDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB1","description":"ICD-GDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44132","description":"Enterectomy cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC0","description":"ICD-FCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther hrvst onl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265T","description":"Im b1 mrw cel ther hrvst onl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med record copy admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9981","description":"Med record copy admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81308","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE1","description":"ICD-FFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB1","description":"ICD-EBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND1","description":"ICD-CAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88245","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE1","description":"ICD-EDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC1","description":"ICD-BACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE0","description":"ICD-BCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB1","description":"ICD-NLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electromyograph biofeedback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0746","description":"Electromyograph biofeedback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE1","description":"ICD-KEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0806","description":"Pov group 2 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF1","description":"ICD-NLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peng benzathine/procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0558","description":"Peng benzathine/procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho abduction hip adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1650","description":"Ho abduction hip adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC1","description":"ICD-IFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC1","description":"ICD-OHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0659T","description":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB1","description":"ICD-KCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES255","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE0","description":"ICD-KHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture aerobic quant other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87071","description":"Culture aerobic quant other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE1","description":"ICD-BIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Odontics eposteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6040","description":"Odontics eposteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD1","description":"ICD-PHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA0","description":"ICD-MKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2217","description":"Foam filled caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA0","description":"ICD-BHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0428","description":"Bls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76019","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","description":"CPT-76019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacemnt lithium ionbatter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7367","description":"Replacemnt lithium ionbatter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrogastrography w/test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91133","description":"Electrogastrography w/test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF1","description":"ICD-OKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF1","description":"ICD-NHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA1","description":"ICD-LEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb skin bone at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11012","description":"Deb skin bone at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA1","description":"ICD-IAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens spher single plano 4.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2100","description":"Lens spher single plano 4.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62281","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID0","description":"ICD-JAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC0","description":"ICD-JHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex custom fab thoraci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0452","description":"Tlso flex custom fab thoraci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36861","description":"Cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peristomal hernia supprt blt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4396","description":"Peristomal hernia supprt blt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB0","description":"ICD-MCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert bladder catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51701","description":"Insert bladder catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90720","description":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2202","description":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluorodopa f-18_ diagnostic_ per mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9602","description":"Fluorodopa f-18_ diagnostic_ per mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB1","description":"ICD-CBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protein western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84182","description":"Protein western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC1","description":"ICD-EBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1086","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","description":"CPT-00140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE0","description":"ICD-MJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA1","description":"ICD-GFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0343U","description":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE0","description":"ICD-OKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80055","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE0","description":"ICD-GDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12011","description":"Rpr f/e/e/n/l/m 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD1","description":"ICD-ACTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7684","description":"Triamcinolone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF1","description":"ICD-OJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME0","description":"ICD-NFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB1","description":"ICD-HAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE1","description":"ICD-OCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB0","description":"ICD-NJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who received cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9806","description":"Patients who received cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA1","description":"ICD-AAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep a/hep b vacc adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90636","description":"Hep a/hep b vacc adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF0","description":"ICD-OCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE1","description":"ICD-IFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC1","description":"ICD-ODYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE230","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE0","description":"ICD-AEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX54","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF1","description":"ICD-KFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB1","description":"ICD-MILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5B","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frenuloplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7963","description":"Frenuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD0","description":"ICD-BIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF1","description":"ICD-OFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9270","description":"Doc no comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB230","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD1","description":"ICD-GHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec sit not prim tumor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8723","description":"Spec sit not prim tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB0","description":"ICD-JFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB0","description":"ICD-KBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37257","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","description":"CPT-37257","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC1","description":"ICD-OGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in lt/non-skilled nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5003","description":"Hospice in lt/non-skilled nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"History of mole changes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1050F","description":"History of mole changes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD0","description":"ICD-GGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE0","description":"ICD-NBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48154","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise mandible lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21040","description":"Excise mandible lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB41","description":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE0","description":"ICD-NHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia removal pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54251","description":"Anesthesia removal pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB1","description":"ICD-GAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/in 2yr dxa not order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9471","description":"W/in 2yr dxa not order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair pul venous stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33726","description":"Repair pul venous stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9494","description":"Hit antibiotic total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES156","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE1","description":"ICD-EDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9040","description":"Injection_ fremanezumab-vfrm_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 8/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22812","description":"Ant fusion 8/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA0","description":"ICD-GFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE1","description":"ICD-IHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31755","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ dual mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2367","description":"Battery charger_ dual mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC1","description":"ICD-GHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28525","description":"Treat toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB0","description":"ICD-EDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88399","description":"Surgical pathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC55","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1972","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1972","description":"HCPCS-L1972","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1016","description":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart chambers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33670","description":"Repair of heart chambers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE1","description":"ICD-NEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20692","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA1","description":"ICD-EFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical social work mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0066","description":"Clinical social work mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF0","description":"ICD-GGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC1","description":"ICD-BFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA1","description":"ICD-OIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amino acid single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82127","description":"Amino acid single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD1","description":"ICD-JEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB0","description":"ICD-GIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA0","description":"ICD-EGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0101","description":"Residential Habilitation 1-3 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC1","description":"ICD-ABIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Critical care first hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99291","description":"Critical care first hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB0","description":"ICD-AFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6608","description":"Gradient compression bandaging supply_ tubular protective absorption padded layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31554","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA56","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplcmt defib w/lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33249","description":"Insj/rplcmt defib w/lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB214","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA0","description":"ICD-NDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9074","description":"Injection_ lumasiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography neck spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72240","description":"Myelography neck spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB1","description":"ICD-NHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB0","description":"ICD-EIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting for tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92071","description":"Contact lens fitting for tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9972","description":"Epoetin beta_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF1","description":"ICD-OEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sphyg/bp app w cuff and stet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4660","description":"Sphyg/bp app w cuff and stet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91323","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","description":"CPT-91323","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB0","description":"ICD-CEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME0","description":"ICD-KIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB0","description":"ICD-GEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I&d abscess p-spine l/s/ls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22015","description":"I&d abscess p-spine l/s/ls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0291","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC1","description":"ICD-PHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB1","description":"ICD-ABAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee cuff suspension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5666","description":"Below knee cuff suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE1","description":"ICD-NAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket hemipelvectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5628","description":"Test socket hemipelvectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD1","description":"ICD-KIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14061","description":"Tis trnfr e/n/e/l10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9933","description":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensve oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0150","description":"Comprehensve oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power adapter_ combo vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0478","description":"Power adapter_ combo vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prednisolone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2650","description":"Prednisolone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Membrane graft or membrane wrap_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4205","description":"Membrane graft or membrane wrap_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t4_n_m0 no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9093","description":"Onc dx rectal t4_n_m0 no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","description":"CPT-00830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC1","description":"ICD-GDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF0","description":"ICD-MDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC0","description":"ICD-KDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9081","description":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt counsld on exam for moles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5005F","description":"Pt counsld on exam for moles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB0","description":"ICD-LFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB1","description":"ICD-FGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64466","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","description":"CPT-64466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22610","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID1","description":"ICD-BFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED1","description":"ICD-FAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA0","description":"ICD-OHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD245","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD1","description":"ICD-AFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5141","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","description":"HCPCS-Q5141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC0","description":"ICD-JHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00872","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","description":"CPT-00872","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB0","description":"ICD-GEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD1","description":"ICD-JAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tiss ex molecul study add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88388","description":"Tiss ex molecul study add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49623","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1202","description":"HCPCS-A1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC1","description":"ICD-JAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE1","description":"ICD-OKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg >4.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11406","description":"Exc tr-ext b9+marg >4.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of hand or finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29280","description":"Strapping of hand or finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE0","description":"ICD-GCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1B","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE1","description":"ICD-OHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF0","description":"ICD-ICBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extremity 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64642","description":"Chemodenerv 1 extremity 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acellular derm matrix implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15777","description":"Acellular derm matrix implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69645","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC46","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB1","description":"ICD-NBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE1","description":"ICD-CEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0918","description":"No satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES354","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE1","description":"ICD-JEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21151","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE1","description":"ICD-AEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carbidopa levodopa enteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7340","description":"Carbidopa levodopa enteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB1","description":"ICD-BBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB0","description":"ICD-NAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB0","description":"ICD-OEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65750","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154A","description":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","description":"CPT-98009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58951","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tibial tubercle hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5020","description":"Tibial tubercle hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC0","description":"ICD-NAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE1","description":"ICD-FEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA1","description":"ICD-BDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF0","description":"ICD-NBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA1","description":"ICD-BGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0505","description":"HCPCS-C0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ladies shoes hightop depth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3217","description":"Ladies shoes hightop depth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ortho dvc repair per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4205","description":"Ortho dvc repair per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gamunex-c/gammaked","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1561","description":"Gamunex-c/gammaked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51727","description":"Cystometrogram w/up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB0","description":"ICD-JHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC1","description":"ICD-GDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB1","description":"ICD-GFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA31","description":"ICD-4LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE1","description":"ICD-LEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Refitting of obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5933","description":"Refitting of obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33645","description":"Revision of heart veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28193","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vestronidase alfa-vjbk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3397","description":"Injection_ vestronidase alfa-vjbk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD0","description":"ICD-IAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98978","description":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME1","description":"ICD-AHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1105","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19369","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of semen fructose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82757","description":"Assay of semen fructose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC0","description":"ICD-KBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB1","description":"ICD-JELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC0","description":"ICD-FAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0407","description":"HCPCS-B0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4035","description":"Cast sup lngleg cylndr ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE0","description":"ICD-KEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC0","description":"ICD-JGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB1","description":"ICD-AGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4022","description":"Cast sup sht arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD1","description":"ICD-KGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE1","description":"ICD-NHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF1","description":"ICD-NKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE1","description":"ICD-FCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE1","description":"ICD-EFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ortho sidebar disconnect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2768","description":"Ortho sidebar disconnect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF1","description":"ICD-GBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB1","description":"ICD-GFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD1","description":"ICD-AAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36218","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/o del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1875","description":"Stent_ coated/cov w/o del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND1","description":"ICD-JAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE1","description":"ICD-KAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB0","description":"ICD-NBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55530","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acylcarnitines quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82017","description":"Acylcarnitines quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE0","description":"ICD-GBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC0","description":"ICD-NKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ipratropium bromide non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7644","description":"Ipratropium bromide non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0829T","description":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belinostat_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9032","description":"Injection_ belinostat_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA1","description":"ICD-KHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect abd tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22905","description":"Rad resect abd tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA0","description":"ICD-EGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB0","description":"ICD-EEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD1","description":"ICD-DERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB1","description":"ICD-NHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE0","description":"ICD-JAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33702","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC1","description":"ICD-HHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD214","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE1","description":"ICD-JIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair_ ped size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1037","description":"Transport chair_ ped size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tooth splitting","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3920","description":"Tooth splitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech threshold audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92555","description":"Speech threshold audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35151","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE0","description":"ICD-BDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB0","description":"ICD-CDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37273","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","description":"CPT-37273","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA1","description":"ICD-OCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC1","description":"ICD-KIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB1","description":"ICD-AHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD1","description":"ICD-DARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA0","description":"ICD-CAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","description":"HCPCS-A9611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID1","description":"ICD-JIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0586T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81327","description":"SEPT9 (Septin9) (eg_ colorectal cancer) methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF1","description":"ICD-AFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF0","description":"ICD-OJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE0","description":"ICD-BEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE1","description":"ICD-GDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface below knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2820","description":"Soft interface below knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA0","description":"ICD-HFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9954","description":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC11","description":"ICD-3HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA1","description":"ICD-KCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","description":"HCPCS-M1391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD0","description":"ICD-LGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455U","description":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC0","description":"ICD-ECAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise bladder/drain ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51045","description":"Incise bladder/drain ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient encounter during the performance period with hospice and palliative care specialty code 17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1365","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC0","description":"ICD-PHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ep & ablate supravent arrhyt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93653","description":"Ep & ablate supravent arrhyt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87491","description":"Chylmd trach dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD0","description":"ICD-GAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung perfusion imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78580","description":"Lung perfusion imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA20","description":"Low Rehab_ ADL Index 0-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE1","description":"ICD-MDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF1","description":"ICD-CFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bypass graft/av fist patency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35686","description":"Bypass graft/av fist patency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8842","description":"Ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Face bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21210","description":"Face bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB1","description":"ICD-ADTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE1","description":"ICD-OLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33927","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75880","description":"Vein x-ray eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool non-portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1310","description":"Whirlpool non-portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB1","description":"ICD-GECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73070","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC1","description":"ICD-NADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA0","description":"ICD-MFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC1","description":"ICD-GDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD1","description":"ICD-ODPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67935","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC0","description":"ICD-GCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF0","description":"ICD-GEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC1","description":"ICD-BHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA1","description":"ICD-CGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA1","description":"ICD-BFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD0","description":"ICD-JIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD0","description":"ICD-MCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME1","description":"ICD-OLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB0","description":"ICD-OJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket shldr disart/tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6684","description":"Test socket shldr disart/tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC1","description":"ICD-NKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of selenium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84255","description":"Assay of selenium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB0","description":"ICD-ODUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repr of anal fistula w/glue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46706","description":"Repr of anal fistula w/glue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy w/taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44127","description":"Enterectomy w/taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF1","description":"ICD-CBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26070","description":"Explore/treat hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Othe therapist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9478","description":"Othe therapist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nudge control elbow lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6637","description":"Nudge control elbow lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD1","description":"ICD-JBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1358","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Formoterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7640","description":"Formoterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID0","description":"ICD-CBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC141","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lepirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1945","description":"Lepirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE1","description":"ICD-BHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF1","description":"ICD-GFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99378","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25135","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC1","description":"ICD-MELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB21","description":"ICD-1DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0727T","description":"Removal and replacement of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE1","description":"ICD-KIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA1","description":"ICD-FGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA1","description":"ICD-KGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brow wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15826","description":"Removal of brow wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve stimulator for tx n&v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0765","description":"Nerve stimulator for tx n&v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB1","description":"ICD-GHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL10","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC1","description":"ICD-DFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA1","description":"ICD-OADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sperm cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55520","description":"Removal of sperm cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB0","description":"ICD-GHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49000","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA1","description":"ICD-OAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC0","description":"ICD-MDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70360","description":"X-ray exam of neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF0","description":"ICD-AETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD0","description":"ICD-CICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA0","description":"ICD-IILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC0","description":"ICD-GDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC1","description":"ICD-KFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB1","description":"ICD-OGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC235","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bypass graft patency/patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35685","description":"Bypass graft patency/patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB1","description":"ICD-DISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA1","description":"ICD-MIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67801","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal scaling 1-3teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4342","description":"Periodontal scaling 1-3teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC0","description":"ICD-BAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93569","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC0","description":"ICD-FGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE1","description":"ICD-JFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","description":"CPT-01926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB0","description":"ICD-PESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67950","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF0","description":"ICD-CFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted molecular pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81479","description":"Unlisted molecular pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA0","description":"ICD-OKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB0","description":"ICD-FCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD1","description":"ICD-FFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","description":"HCPCS-Q4379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82570","description":"Assay of urine creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Organic acids qual each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83919","description":"Organic acids qual each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0637U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0637U","description":"CPT-0637U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29836","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22869","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symes met fr leath socket ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5060","description":"Symes met fr leath socket ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB0","description":"ICD-NHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC0","description":"ICD-AHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of eyelid by suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67875","description":"Closure of eyelid by suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ blinatumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9039","description":"Injection_ blinatumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF0","description":"ICD-ADUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quant pupillometry w/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341T","description":"Quant pupillometry w/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6595","description":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF1","description":"ICD-JEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD1","description":"ICD-FIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB1","description":"ICD-CHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML50","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect talus/calcaneus tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27647","description":"Resect talus/calcaneus tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hallux implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8642","description":"Hallux implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21172","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE0","description":"ICD-OFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen mlt ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33264","description":"Rmvl & rplcmt dfb gen mlt ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen prsmptv 1 class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80302","description":"Drug screen prsmptv 1 class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mast rad urban type","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19306","description":"Mast rad urban type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC1","description":"ICD-FINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA0","description":"ICD-JBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB156","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF0","description":"ICD-KGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE0","description":"ICD-LHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA1","description":"ICD-IHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB1","description":"ICD-FEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj filgrastim gcsf biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5101","description":"Inj filgrastim gcsf biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair maxillofacial defects","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7955","description":"Repair maxillofacial defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE0","description":"ICD-DDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB0","description":"ICD-CIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA1","description":"ICD-JDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA0","description":"ICD-KINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA0","description":"ICD-LAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE1","description":"ICD-GAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC0","description":"ICD-KEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA1","description":"ICD-KIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair ortho appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8691","description":"Repair ortho appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB1","description":"ICD-JCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraosseous joint stblztion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335T","description":"Extraosseous joint stblztion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC1","description":"ICD-FCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Demonstrate use home inr mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0248","description":"Demonstrate use home inr mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB0","description":"ICD-KCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB0","description":"ICD-CFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF1","description":"ICD-JFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic procd strg endur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0237","description":"Therapeutic procd strg endur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect forearm/wrist tum<3cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25077","description":"Resect forearm/wrist tum<3cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7032","description":"Replacement nasal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC0","description":"ICD-OAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantable pump replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0786","description":"Implantable pump replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Swallow d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8998","description":"Swallow d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA0","description":"ICD-OINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE0","description":"ICD-FAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9703","description":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF1","description":"ICD-DFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC1","description":"ICD-HIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD1","description":"ICD-GIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC0","description":"ICD-OCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA0","description":"ICD-GGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF0","description":"ICD-CDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA0","description":"ICD-FIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24666","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for breast x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19030","description":"Injection for breast x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC1","description":"ICD-KFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE0","description":"ICD-GDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD1","description":"ICD-CIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporine oral 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7502","description":"Cyclosporine oral 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF1","description":"ICD-ACCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD0","description":"ICD-KESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB1","description":"ICD-NGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC135","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0791T","description":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo drain lymphocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49323","description":"Laparo drain lymphocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA1","description":"ICD-OGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE1","description":"ICD-MIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF1","description":"ICD-ABMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE0","description":"ICD-KGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD1","description":"ICD-FFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0677","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0677","description":"HCPCS-G0677","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD0","description":"ICD-BCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC0","description":"ICD-CFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB1","description":"ICD-OGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25295","description":"Release wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16076","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF0","description":"ICD-GDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA0","description":"ICD-FBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD1","description":"ICD-CFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Modification of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92325","description":"Modification of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC250","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF1","description":"ICD-JCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx iv admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79101","description":"Nuclear rx iv admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/o hemodyn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75887","description":"Vein x-ray liver w/o hemodyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7643","description":"Glycopyrrolate comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49014","description":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC0","description":"ICD-KANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA0","description":"ICD-GAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63740","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA0","description":"ICD-FDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl 2 srfc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6610","description":"Onlay cst hgh nbl mtl 2 srfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart-vein defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33732","description":"Repair heart-vein defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE205","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29907","description":"Subtalar arthro w/fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cognit assessed and reviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1494F","description":"Cognit assessed and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97001","description":"Pt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5160","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","description":"HCPCS-Q5160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD1","description":"ICD-BIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF0","description":"ICD-CDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe/needle_ cryo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2618","description":"Probe/needle_ cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE0","description":"ICD-DGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF0","description":"ICD-LGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15821","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB0","description":"ICD-FIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Child sitting services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1009","description":"Child sitting services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5152","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","description":"HCPCS-Q5152","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB0","description":"ICD-FHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC0","description":"ICD-OEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE1","description":"ICD-FCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test for urine cystines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82615","description":"Test for urine cystines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC0","description":"ICD-NDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB0","description":"ICD-JGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD0","description":"ICD-NJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF1","description":"ICD-FFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00548","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","description":"CPT-00548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC0","description":"ICD-GIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE120","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24430","description":"Repair of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE1","description":"ICD-FDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD0","description":"ICD-HCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89051","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA1","description":"ICD-KEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6564","description":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD0","description":"ICD-ODOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE0","description":"ICD-HDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diab shoe for density insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5500","description":"Diab shoe for density insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA1","description":"ICD-OJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB0","description":"ICD-CIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t1-4 no dx prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9086","description":"Onc dx colon t1-4 no dx prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC0","description":"ICD-AIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB0","description":"ICD-CGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meg evoked single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95966","description":"Meg evoked single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54050","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens variab asphericity sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2410","description":"Lens variab asphericity sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64484","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen Test For Platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9987","description":"Pathogen Test For Platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB0","description":"ICD-OJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy pouch liq deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4394","description":"Ostomy pouch liq deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs other vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36406","description":"Bl draw <3 yrs other vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93316","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0479U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","description":"CPT-0479U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB0","description":"ICD-GBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD1","description":"ICD-EGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD0","description":"ICD-BHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054U","description":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF1","description":"ICD-NLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD154","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB1","description":"ICD-FDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD1","description":"ICD-KGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of windpipe airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31502","description":"Change of windpipe airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE0","description":"ICD-OBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30124","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA0","description":"ICD-IIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE1","description":"ICD-NGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB113","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF0","description":"ICD-KIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE0","description":"ICD-JHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA0","description":"ICD-MHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef <40% or dep lv sys fcn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8934","description":"Lvef <40% or dep lv sys fcn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED1","description":"ICD-CBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE0","description":"ICD-IIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE0","description":"ICD-MBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC1","description":"ICD-ADBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466T","description":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD0","description":"ICD-MDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC0","description":"ICD-KBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX60","description":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD0","description":"ICD-BACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507T","description":"Near-infrared dual imaging (ie_ simultaneous reflective and trans-illuminated light) of meibomian glands_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 3 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74021","description":"Radiologic examination_ abdomen; 3 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9247","description":"1 med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD1","description":"ICD-NIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD1","description":"ICD-CAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC1","description":"ICD-CGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND0","description":"ICD-FCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33425","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alpha 1 proteinase inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0256","description":"Alpha 1 proteinase inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0815T","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD1","description":"ICD-OBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB0","description":"ICD-JBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF0","description":"ICD-BBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8713","description":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB0","description":"ICD-BEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1707","description":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26725","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1026T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1026T","description":"CPT-1026T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup body cast fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4002","description":"Cast sup body cast fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC0","description":"ICD-NAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope procedure liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47379","description":"Laparoscope procedure liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1702","description":"HCPCS-A1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0600U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","description":"CPT-0600U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82489","description":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB0","description":"ICD-NFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1066T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1066T","description":"CPT-1066T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33120","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0973T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","description":"CPT-0973T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC0","description":"ICD-OIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF1","description":"ICD-ADCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC0","description":"ICD-BIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB1","description":"ICD-MITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA0","description":"ICD-CFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF0","description":"ICD-PJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31635","description":"Bronchoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64582","description":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB0","description":"ICD-MDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA1","description":"ICD-CGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hippotherapy per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8940","description":"Hippotherapy per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB110","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID0","description":"ICD-JEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA0","description":"ICD-NGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA1","description":"ICD-MAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93931","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81545","description":"Oncology thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF1","description":"ICD-FHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive bandage_ first-aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6413","description":"Adhesive bandage_ first-aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE0","description":"ICD-FCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE1","description":"ICD-PHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC0","description":"ICD-ODQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB0","description":"ICD-BCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","description":"CPT-01472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC0","description":"ICD-CCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC1","description":"ICD-AALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC0","description":"ICD-GBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC1","description":"ICD-JBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF0","description":"ICD-FDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA0","description":"ICD-DAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <=16 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6222","description":"Gauze <=16 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA0","description":"ICD-NJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA0","description":"ICD-FDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA0","description":"ICD-MAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB0","description":"ICD-MICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB1","description":"ICD-AEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant maintenance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6080","description":"Implant maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8G","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trapezius sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1070","description":"Trapezius sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD0","description":"ICD-IDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance response/treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0998","description":"Ambulance response/treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF1","description":"ICD-MDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF0","description":"ICD-PFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Melanomaajcc stage 0 or ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3322F","description":"Melanomaajcc stage 0 or ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frontier extended stay demo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9140","description":"Frontier extended stay demo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE1","description":"ICD-FBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chore services per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5120","description":"Chore services per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology/Hematology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4019","description":"Oncology/Hematology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko elastic with joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1810","description":"Ko elastic with joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC1","description":"ICD-EAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF0","description":"ICD-OGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF1","description":"ICD-OFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE1","description":"ICD-AEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead wires_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4557","description":"Lead wires_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC1","description":"ICD-JGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cxr doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3006F","description":"Cxr doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB0","description":"ICD-HIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0488T","description":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA1","description":"ICD-OIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph scope w/submucous inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43201","description":"Esoph scope w/submucous inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1277","description":"Colorectal cancer screening results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD0","description":"ICD-OHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA1","description":"ICD-EGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB1","description":"ICD-EIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB1","description":"ICD-NILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE0","description":"ICD-AHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD0","description":"ICD-OKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4017","description":"Cast sup lng arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE0","description":"ICD-FIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/stone remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52352","description":"Cystouretero w/stone remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD0","description":"ICD-IGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"12-24hr sealed lead acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0733","description":"12-24hr sealed lead acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB0","description":"ICD-OIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE1","description":"ICD-CAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4D","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA0","description":"ICD-KETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA1","description":"ICD-FHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA1","description":"ICD-FHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43820","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE1","description":"ICD-OFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC0","description":"ICD-KDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC1","description":"ICD-GAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin each add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90472","description":"Immunization admin each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA1","description":"ICD-GCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC0","description":"ICD-FDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA1","description":"ICD-BEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cecostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49442","description":"Place cecostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove rectum w/reservoir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45119","description":"Remove rectum w/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us urine capacity measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51798","description":"Us urine capacity measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove iris and lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66600","description":"Remove iris and lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99383","description":"Prev visit new age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE0","description":"ICD-GIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB0","description":"ICD-MGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl oral cushion combo mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7028","description":"Repl oral cushion combo mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD220","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE1","description":"ICD-CEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther/diag concurrent inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96368","description":"Ther/diag concurrent inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC214","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE1","description":"ICD-PGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA211","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA1","description":"ICD-KAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB1","description":"ICD-OHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE0","description":"ICD-FFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC0","description":"ICD-GHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC0","description":"ICD-JBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD1","description":"ICD-LCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA1","description":"ICD-NHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC1","description":"ICD-GGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA1","description":"ICD-CCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp w/optical endomicroscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397T","description":"Ercp w/optical endomicroscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69716","description":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB1","description":"ICD-GEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB1","description":"ICD-IBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC0","description":"ICD-JIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; removal_ each balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550T","description":"Transperineal periurethral balloon continence device; removal_ each balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA0","description":"ICD-PFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA43","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC0","description":"ICD-KIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71550","description":"MRI chest w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD0","description":"ICD-KADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD0","description":"ICD-FCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB0","description":"ICD-KDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81214","description":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB0","description":"ICD-OLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo spiral prefabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1951","description":"Afo spiral prefabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC1","description":"ICD-GEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl electrode for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0609","description":"Repl electrode for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE1","description":"ICD-OGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA1","description":"ICD-LISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test electric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86923","description":"Compatibility test electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appendico-vesicostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50845","description":"Appendico-vesicostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82955","description":"Assay of g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a doula birth worker_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1033","description":"Services performed by a doula birth worker_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC0","description":"ICD-IGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD1","description":"ICD-ICUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of complications","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9930","description":"Treatment of complications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA0","description":"ICD-ECBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary reflex study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51792","description":"Urinary reflex study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk back check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5686","description":"Bk back check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC106","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF1","description":"ICD-DHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA0","description":"ICD-MCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD1","description":"ICD-CCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA1","description":"ICD-CAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In-hospital on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99026","description":"In-hospital on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC0","description":"ICD-JGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft great toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20973","description":"Bone/skin graft great toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs cranial lesion simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61796","description":"Srs cranial lesion simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6076","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC0","description":"ICD-FBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam two surfaces permane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2150","description":"Amalgam two surfaces permane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED0","description":"ICD-CBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC130","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA1","description":"ICD-FEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser in situ keratomileusis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0800","description":"Laser in situ keratomileusis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF0","description":"ICD-FBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE1","description":"ICD-KGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8H","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB0","description":"ICD-NBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA0","description":"ICD-BIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC0","description":"ICD-JHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26541","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF1","description":"ICD-FEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB1","description":"ICD-MGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8573","description":"Stk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE1","description":"ICD-OFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA0","description":"ICD-GIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97022","description":"Whirlpool therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD0","description":"ICD-OJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC0","description":"ICD-FBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF0","description":"ICD-MJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0801","description":"HCPCS-A0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24331","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD0","description":"ICD-BFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD1","description":"ICD-ABLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6006","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF1","description":"ICD-CICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low (or very low) risk of recurrence_ prostate cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9706","description":"Low (or very low) risk of recurrence_ prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0023","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF1","description":"ICD-MIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peri-px pacemaker device evl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93286","description":"Peri-px pacemaker device evl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF0","description":"ICD-NHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE1","description":"ICD-PESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB1","description":"ICD-OIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA1","description":"ICD-OCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral con def inter plt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5958","description":"Intraoral con def inter plt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF0","description":"ICD-OLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of pelvis brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20662","description":"Application of pelvis brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1035T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1035T","description":"CPT-1035T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","description":"HCPCS-Q0521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA1","description":"ICD-CABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC1","description":"ICD-PCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1096","description":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338U","description":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE1","description":"ICD-OHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","description":"CPT-00926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF0","description":"ICD-BHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD0","description":"ICD-BDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC1","description":"ICD-CDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54300","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC160","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA0","description":"ICD-DERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA1","description":"ICD-ODKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD0","description":"ICD-NJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom sleep apnea appliance fabrication and placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9947","description":"Custom sleep apnea appliance fabrication and placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB1","description":"ICD-CGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC1","description":"ICD-KFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC0","description":"ICD-FBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8628","description":"No surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB0","description":"ICD-NKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15833","description":"Excise excessive skin leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC0","description":"ICD-JEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD0","description":"ICD-JBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15944","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME0","description":"ICD-ABME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50610","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF0","description":"ICD-ECIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC241","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF1","description":"ICD-NKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB1","description":"ICD-OGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1095","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis apoe alzheimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3852","description":"Dna analysis apoe alzheimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA21","description":"ICD-1HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87468","description":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90691","description":"Typhoid vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0861T","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46946","description":"Remove by ligat int hem grps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20822","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA0","description":"ICD-NEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9036","description":"Injection_ patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF0","description":"ICD-NKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52277","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01925","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","description":"CPT-01925","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF0","description":"ICD-FELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF1","description":"ICD-OEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB0","description":"ICD-PCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC21","description":"ICD-2JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC0","description":"ICD-KADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF0","description":"ICD-MJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD1","description":"ICD-NBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF1","description":"ICD-GBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND1","description":"ICD-KGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4226","description":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA1","description":"ICD-FAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD0","description":"ICD-EHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337T","description":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93784","description":"Ambulatory bp monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histoplasmosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86510","description":"Histoplasmosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD0","description":"ICD-OLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE0","description":"ICD-IAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD0","description":"ICD-OJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD1","description":"ICD-CAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF1","description":"ICD-GGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE1","description":"ICD-KHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA0","description":"ICD-FBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC1","description":"ICD-FIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL44","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA1","description":"ICD-JBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD1","description":"ICD-MBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53215","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Powered w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2610","description":"Powered w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC0","description":"ICD-DHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE1","description":"ICD-AFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE0","description":"ICD-OCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE1","description":"ICD-GDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED1","description":"ICD-BIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr convex <=4 sq i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4409","description":"Ost skn barr convex <=4 sq i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy into cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96450","description":"Chemotherapy into cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43288","description":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE1","description":"ICD-CDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC1","description":"ICD-IEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB1","description":"ICD-LESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB1","description":"ICD-OFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF1","description":"ICD-GCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99335","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part hand thumb rem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6000","description":"Part hand thumb rem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF0","description":"ICD-ICIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback peri/uro/rectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90911","description":"Biofeedback peri/uro/rectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy faceplt/silicone ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4384","description":"Ostomy faceplt/silicone ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2189","description":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141U","description":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC1","description":"ICD-FCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0317","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57335","description":"Repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52332","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59821","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF1","description":"ICD-CGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD1","description":"ICD-EGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB0","description":"ICD-JDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF0","description":"ICD-EGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Finding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1735","description":"Employment - Job Finding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA0","description":"ICD-JCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp pop-tibl peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35587","description":"Vein byp pop-tibl peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext 7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12034","description":"Intmd rpr s/tr/ext 7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28260","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic source imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8035","description":"Magnetic source imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC0","description":"ICD-NBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1705","description":"HCPCS-B1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF0","description":"ICD-EFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","description":"CPT-76016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80351","description":"Cannabinoids synthetic 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27347","description":"Remove knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate conc sol add 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4766","description":"Dialysate conc sol add 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA53","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB213","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME0","description":"ICD-GIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB1","description":"ICD-HAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1076T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1076T","description":"CPT-1076T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF0","description":"ICD-NHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA1","description":"ICD-IHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB1","description":"ICD-MFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD0","description":"ICD-CDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC1","description":"ICD-IDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX50","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD1","description":"ICD-AEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD1","description":"ICD-OFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7345","description":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB0","description":"ICD-GAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0204","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0204","description":"CDT-D0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial knee/shin system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5840","description":"Multi-axial knee/shin system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55175","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF0","description":"ICD-ODLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0633","description":"Lso sc r pos/lat pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0102","description":"HCPCS-C0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF0","description":"ICD-FEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB14","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA0","description":"ICD-ODIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9857","description":"Patient admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC1","description":"ICD-MGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","description":"CPT-00120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bile duct endoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47550","description":"Bile duct endoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monit store cryo embryo 30 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4040","description":"Monit store cryo embryo 30 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86812","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB0","description":"ICD-CFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comm psy sup tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0037","description":"Comm psy sup tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF1","description":"ICD-CHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC0","description":"ICD-OAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD1","description":"ICD-CCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461U","description":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procuren or other growth fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9055","description":"Procuren or other growth fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crgvr prov w/ ed addl rsrcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4322F","description":"Crgvr prov w/ ed addl rsrcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA134","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB0","description":"ICD-OCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9932","description":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","description":"HCPCS-J2428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA1","description":"ICD-EAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED0","description":"ICD-MCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61313","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate (hope)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0209","description":"Injection_ sodium thiosulfate (hope)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE1","description":"ICD-GBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA0","description":"ICD-KCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD0","description":"ICD-OATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD0","description":"ICD-NHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0655U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0655U","description":"CPT-0655U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA1","description":"ICD-AGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF0","description":"ICD-FENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC0","description":"ICD-BEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40761","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB0","description":"ICD-OFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1053","description":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC1","description":"ICD-KFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flex/ext/rotation wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6624","description":"Flex/ext/rotation wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orth dev repair/repl minor p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4210","description":"Orth dev repair/repl minor p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE0","description":"ICD-NKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD240","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy nerve face muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64612","description":"Destroy nerve face muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL42","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81451","description":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22634","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD0","description":"ICD-BDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75451","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA1","description":"ICD-KBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81443","description":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE0","description":"ICD-PDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF0","description":"ICD-BFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC1","description":"ICD-MEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB0","description":"ICD-FINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8E","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9482","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE1","description":"ICD-MIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF0","description":"ICD-AIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj multihance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9578","description":"Inj multihance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0184","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB31","description":"ICD-1DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86851","description":"Anesth kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA1","description":"ICD-BAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD0","description":"ICD-KFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE1","description":"ICD-CDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contracted services per day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1022","description":"Contracted services per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB1","description":"ICD-OBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB1","description":"ICD-AIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC0","description":"ICD-PBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6208","description":"Contact layer > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE0","description":"ICD-CCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC0","description":"ICD-FCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD0","description":"ICD-NJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB0","description":"ICD-CCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF1","description":"ICD-NHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB1","description":"ICD-JBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0127U","description":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB0","description":"ICD-OGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81320","description":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA0","description":"ICD-OFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain open retroperi abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49060","description":"Drain open retroperi abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC1","description":"ICD-ECLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312U","description":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lsh w/t/o ut 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58542","description":"Lsh w/t/o ut 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD1","description":"ICD-GAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC1","description":"ICD-GILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1071T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1071T","description":"CPT-1071T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF0","description":"ICD-JAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF0","description":"ICD-OAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC1","description":"ICD-JBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF1","description":"ICD-FHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA1","description":"ICD-OHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF1","description":"ICD-LBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB1","description":"ICD-LCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ single_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2620","description":"Pmkr_ single_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC11","description":"ICD-1JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB1","description":"ICD-BHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA0","description":"ICD-NAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB1","description":"ICD-OGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD1","description":"ICD-ODLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF0","description":"ICD-CAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC0","description":"ICD-KILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF1","description":"ICD-GFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB0","description":"ICD-GDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF0","description":"ICD-MIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supportive care for neurodegenerative conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0004","description":"Supportive care for neurodegenerative conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infus pump statio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9006","description":"Parenteral infus pump statio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB21","description":"ICD-3JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF0","description":"ICD-CBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67318","description":"Revise eye muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC1","description":"ICD-CCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0602","description":"Manual breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise hand/foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64704","description":"Revise hand/foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD1","description":"ICD-NGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA1","description":"ICD-JEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB1","description":"ICD-GESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9982","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c screen high risk/other","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0472","description":"Hep c screen high risk/other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD1","description":"ICD-NGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD0","description":"ICD-KGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0521","description":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice general care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2045","description":"Hospice general care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC0","description":"ICD-OJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28261","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE0","description":"ICD-MGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA0","description":"ICD-KGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC0","description":"ICD-NDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radium ra223 dichloride ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9606","description":"Radium ra223 dichloride ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add instep velcro clo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3580","description":"O shoe add instep velcro clo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB121","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0605","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","description":"HCPCS-J0605","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81178","description":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF0","description":"ICD-PKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF1","description":"ICD-JAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD0","description":"ICD-GIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64625","description":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD0","description":"ICD-ACBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD1","description":"ICD-GGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF0","description":"ICD-FALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA46","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debridement of a periimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6101","description":"Debridement of a periimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD115","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xcm biologic tiss matrix 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4142","description":"Xcm biologic tiss matrix 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF0","description":"ICD-FDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE1","description":"ICD-NAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF1","description":"ICD-OIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9759","description":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE1","description":"ICD-OGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD0","description":"ICD-CAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA0","description":"ICD-NAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam stability fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83662","description":"Foam stability fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE1","description":"ICD-NANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA0","description":"ICD-NJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD0","description":"ICD-PCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF0","description":"ICD-KHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA0","description":"ICD-FFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CHLAMYDIA TRACHOMATIS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87320","description":"IAAD IA CHLAMYDIA TRACHOMATIS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD0","description":"ICD-MFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED0","description":"ICD-ICED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA0","description":"ICD-BHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1367","description":"Quality care for the treatment of ear_ nose_ and throat disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genetic test brugada","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3861","description":"Genetic test brugada","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC0","description":"ICD-FEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4A","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43112","description":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33617","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE0","description":"ICD-OEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC0","description":"ICD-MLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1035","description":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA1","description":"ICD-GETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72196","description":"MRI pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01758","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","description":"CPT-01758","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32668","description":"Thoracoscopy w/w resect diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE1","description":"ICD-JIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE224","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA1","description":"ICD-ODBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","description":"HCPCS-M1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE1","description":"ICD-CFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA0","description":"ICD-GISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28090","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF0","description":"ICD-AHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft face/nk/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15275","description":"Skin sub graft face/nk/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE1","description":"ICD-KATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA0","description":"ICD-MCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise sublingual gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42450","description":"Excise sublingual gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC0","description":"ICD-BILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81459","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symptom&sign symm polyneuro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1500F","description":"Symptom&sign symm polyneuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC1","description":"ICD-JIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","description":"HCPCS-E1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF1","description":"ICD-BFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laiv vacc pandemic intranasl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90664","description":"Laiv vacc pandemic intranasl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC1","description":"ICD-OJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA1","description":"ICD-HESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC0","description":"ICD-EHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB244","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE1","description":"ICD-BIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB1","description":"ICD-FCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC1","description":"ICD-BGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA0","description":"ICD-JCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41005","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF0","description":"ICD-GAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB1","description":"ICD-PGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 14 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173U","description":"PSYC GEN ALYS PANEL 14 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plastazote sandal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3265","description":"Plastazote sandal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF0","description":"ICD-OEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap revise/remv eltrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43648","description":"Lap revise/remv eltrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA1","description":"ICD-JDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC21","description":"ICD-3BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF0","description":"ICD-AILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC1","description":"ICD-BINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE1","description":"ICD-NFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA0","description":"ICD-MIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB0","description":"ICD-BDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose in lac ringers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7121","description":"5% dextrose in lac ringers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF0","description":"ICD-NAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0B","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5215","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0280U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable gas oxygen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0738","description":"Portable gas oxygen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC1","description":"ICD-KFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE0","description":"ICD-CEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB1","description":"ICD-DCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC23","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE0","description":"ICD-OAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF0","description":"ICD-IGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1073T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1073T","description":"CPT-1073T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ankle x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27648","description":"Injection for ankle x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE0","description":"ICD-CIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electric breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0603","description":"Electric breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND1","description":"ICD-OGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF0","description":"ICD-NJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73503","description":"X-ray exam hip uni 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF0","description":"ICD-MILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC1","description":"ICD-JADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11306","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB1","description":"ICD-NKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye water bath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76513","description":"Echo exam of eye water bath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE1","description":"ICD-CFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmv ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90291","description":"Cmv ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA0","description":"ICD-BEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gene test niemann-pick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3849","description":"Gene test niemann-pick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC0","description":"ICD-FEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alarm symp assessed-absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1070F","description":"Alarm symp assessed-absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 1-2 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP02","description":"Auto.test pane pricing code_ 1-2 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF0","description":"ICD-GBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB250","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB0","description":"ICD-FIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC1","description":"ICD-BHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB1","description":"ICD-OESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC1","description":"ICD-FDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED1","description":"ICD-NDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB1","description":"ICD-OGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8044","description":"Hemi-facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB0","description":"ICD-PBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA54","description":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0871","description":"Pwc gp 4 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-help/peer svc per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0038","description":"Self-help/peer svc per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37280","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","description":"CPT-37280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC0","description":"ICD-PEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA0","description":"ICD-GEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA0","description":"ICD-MFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF1","description":"ICD-CBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB1","description":"ICD-NCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL42","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3342F","description":"Mammo assess bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND1","description":"ICD-GEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA1","description":"ICD-OLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flotufolastat f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9608","description":"Flotufolastat f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE1","description":"ICD-OJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9876","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF1","description":"ICD-OITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA1","description":"ICD-NGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82544","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC1","description":"ICD-HBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF0","description":"ICD-FGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE260","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF1","description":"ICD-DDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2028","description":"Sex offend tx svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB0","description":"ICD-KBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61570","description":"Remove foreign body brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home vent non-invasive inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0466","description":"Home vent non-invasive inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB1","description":"ICD-PLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54408","description":"Repair multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD114","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF1","description":"ICD-NIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB1","description":"ICD-MHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0923T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","description":"CPT-0923T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF1","description":"ICD-MALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92557","description":"Comprehensive hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ ns_ non-hdrir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1719","description":"Brachytx_ ns_ non-hdrir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crown pe","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2931","description":"Prefab stnlss steel crown pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA0","description":"ICD-LEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB0","description":"ICD-PDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF0","description":"ICD-CDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/2.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2204","description":"Lens sphcy bifocal 4.00d/2.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX07","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20611","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB1","description":"ICD-EFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE0","description":"ICD-AILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up/reassessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0316","description":"Follow-up/reassessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE1","description":"ICD-DIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF0","description":"ICD-NHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64788","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB1","description":"ICD-FDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26034","description":"Treat hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib not presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9440","description":"P2y inhib not presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA0","description":"ICD-DDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0513","description":"Disp fee inhal drugs/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8040","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quan lamotrigine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80175","description":"Drug screen quan lamotrigine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND0","description":"ICD-JEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF0","description":"ICD-GHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC0","description":"ICD-BHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD1","description":"ICD-BEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transposition ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58825","description":"Transposition ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41120","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE1","description":"ICD-FATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii (porcine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7191","description":"Factor viii (porcine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB1","description":"ICD-CCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF0","description":"ICD-OHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plastic mod low ext pad/line","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2275","description":"Plastic mod low ext pad/line","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Creatine isoforms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82554","description":"Creatine isoforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans care mgmt 7 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99496","description":"Trans care mgmt 7 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel motor repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2368","description":"Pwr wc drivewheel motor repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF0","description":"ICD-BGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28230","description":"Incision of foot tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27613","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3D","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC0","description":"ICD-NGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD1","description":"ICD-CCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transvaginal us obstetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76817","description":"Transvaginal us obstetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35103","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0024U","description":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF0","description":"ICD-IBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical conference by physic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0220","description":"Medical conference by physic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE1","description":"ICD-GCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC1","description":"ICD-KCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0442","description":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA0","description":"ICD-KAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE1","description":"ICD-NGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB1","description":"ICD-EDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27724","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC0","description":"ICD-GBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1133","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucose monitor platforms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4255","description":"Glucose monitor platforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC1","description":"ICD-OEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TOTAL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4330","description":"TOTAL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5159","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","description":"HCPCS-Q5159","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB0","description":"ICD-OFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1401","description":"HCPCS-B1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82978","description":"Assay of glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of liver duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47400","description":"Incision of liver duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB1","description":"ICD-JHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0101","description":"HCPCS-B0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1901","description":"HCPCS-C1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA140","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00528","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","description":"CPT-00528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/pseudobulb affect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3756F","description":"Pt w/pseudobulb affect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22902","description":"Exc abd les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC0","description":"ICD-EBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syst corticosteroids not rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4136F","description":"Syst corticosteroids not rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC0","description":"ICD-CBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC1","description":"ICD-CEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electric heat pad standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0210","description":"Electric heat pad standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD1","description":"ICD-GAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC1","description":"ICD-HGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA0","description":"ICD-NHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand tum deep < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26116","description":"Exc hand tum deep < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional electric stim nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0770","description":"Functional electric stim nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML46","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF1","description":"ICD-CDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0258U","description":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF1","description":"ICD-JINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC11","description":"ICD-2IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB154","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC1","description":"ICD-OKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD1","description":"ICD-JIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD1","description":"ICD-GIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1223","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC1","description":"ICD-GAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF1","description":"ICD-CBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA1","description":"ICD-GBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF1","description":"ICD-JEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cocoon membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4264","description":"Cocoon membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF0","description":"ICD-FGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF1","description":"ICD-NBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33500","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of stomach nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64755","description":"Incision of stomach nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66700","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX30","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD1","description":"ICD-KHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB1","description":"ICD-IHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE1","description":"ICD-CBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC0","description":"ICD-JIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0863","description":"Pwc gp3 vhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86003","description":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26490","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23174","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"remove erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7210","description":"remove erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE116","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA0","description":"ICD-ODTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND0","description":"ICD-KHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE0","description":"ICD-NDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC0","description":"ICD-FFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD0","description":"ICD-GIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB21","description":"ICD-2DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA1","description":"ICD-BADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53080","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6945","description":"Elbow disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0650T","description":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD1","description":"ICD-OLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0553T","description":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC1","description":"ICD-OHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subs eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1121F","description":"Subs eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tempr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278T","description":"Tempr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED0","description":"ICD-BCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE0","description":"ICD-CHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behind ear binaur hearing ai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5140","description":"Behind ear binaur hearing ai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3061F","description":"Neg microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","description":"HCPCS-Q4376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat neck spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22326","description":"Treat neck spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF0","description":"ICD-OLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0131","description":"Acetaminophen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38510","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA1","description":"ICD-KEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc neg elder mal no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8734","description":"Doc neg elder mal no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC1","description":"ICD-MICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF0","description":"ICD-KHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB1","description":"ICD-CBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF1","description":"ICD-AGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4349","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","description":"HCPCS-Q4349","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE0","description":"ICD-NGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB1","description":"ICD-GDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD1","description":"ICD-CEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE0","description":"ICD-BAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA1","description":"ICD-KCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close nephrovisceral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50525","description":"Close nephrovisceral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD225","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC0","description":"ICD-KFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF1","description":"ICD-NFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28531","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery/speech prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31611","description":"Surgery/speech prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE1","description":"ICD-MJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF0","description":"ICD-FEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration - non-resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6107","description":"guided tissue regeneration - non-resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD0","description":"ICD-AHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26607","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL13","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE1","description":"ICD-NGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0107","description":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD0","description":"ICD-ECDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoride applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5986","description":"Fluoride applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA0","description":"ICD-JFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC0","description":"ICD-JADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD1","description":"ICD-PJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD136","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","description":"CPT-98013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA1","description":"ICD-OGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE1","description":"ICD-OJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA0","description":"ICD-PJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE0","description":"ICD-NLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA0","description":"ICD-AGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB0","description":"ICD-OGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE0","description":"ICD-GHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80306","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC0","description":"ICD-PGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB1","description":"ICD-OFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE1","description":"ICD-CHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped wc modify width adjustm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1011","description":"Ped wc modify width adjustm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF0","description":"ICD-OJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0D","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD0","description":"ICD-MABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE0","description":"ICD-FHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91313","description":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE1","description":"ICD-GHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB0","description":"ICD-OETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ovulation tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84830","description":"Ovulation tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB1","description":"ICD-ECHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX13","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE1","description":"ICD-NBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE1","description":"ICD-PJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62141","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC0","description":"ICD-GBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27097","description":"Revision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo_ walk boot type_ cus fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4631","description":"Afo_ walk boot type_ cus fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion cable hip pelv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2050","description":"Hkafo torsion cable hip pelv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0108","description":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA1","description":"ICD-GBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PelloGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4320","description":"PelloGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay aminolevulinic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82135","description":"Assay aminolevulinic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC0","description":"ICD-KHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE1","description":"ICD-MFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9952","description":"Complete occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB0","description":"ICD-JCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical nutrition indiv in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97802","description":"Medical nutrition indiv in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61556","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt maxilla","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0382","description":"Cone beam ct capt maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thiopurine S-methyltransferase (TPMT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84433","description":"Thiopurine S-methyltransferase (TPMT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE0","description":"ICD-KHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB1","description":"ICD-BHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8969","description":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA1","description":"ICD-GGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ASPERGILLUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87305","description":"IAAD IA ASPERGILLUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA0","description":"ICD-NACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Canalith repositioning proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95992","description":"Canalith repositioning proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio not given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4042F","description":"Doc antibio not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33031","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD0","description":"ICD-HDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Completion pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32488","description":"Completion pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Root canal therapy 3 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3330","description":"Root canal therapy 3 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB1","description":"ICD-KATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6320","description":"Shoulder passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA0","description":"ICD-BIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45505","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil ed waiver_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2012","description":"Habil ed waiver_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78429","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC11","description":"ICD-3LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trismus appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5937","description":"Trismus appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA0","description":"ICD-CAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm pair wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0112","description":"Crutch underarm pair wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC1","description":"ICD-KDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB1","description":"ICD-MLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2104","description":"Spherocylindr 4.00d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44238","description":"Laparoscope proc intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58301","description":"Remove intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE214","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA217","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF1","description":"ICD-NDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated porcelain/ceramic crown - permanent tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2928","description":"Prefabricated porcelain/ceramic crown - permanent tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35876","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC0","description":"ICD-EEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1190","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC0","description":"ICD-FDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx spine process fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22305","description":"Closed tx spine process fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23035","description":"Drain shoulder bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pap oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7044","description":"Pap oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA0","description":"ICD-NBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC0","description":"ICD-JFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8H","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB1","description":"ICD-KDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1484","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","description":"HCPCS-M1484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE0","description":"ICD-JHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC24","description":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD1","description":"ICD-FBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis type 2 posit jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2570","description":"Hip clevis type 2 posit jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic casts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0470","description":"Diagnostic casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24341","description":"Repair arm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB0","description":"ICD-NHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4206","description":"1 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358U","description":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF1","description":"ICD-BDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE0","description":"ICD-LCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE0","description":"ICD-BFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB56","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA1","description":"ICD-KADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33910","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF1","description":"ICD-KFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advanced life support mileag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0390","description":"Advanced life support mileag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB1","description":"ICD-PBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert silicone gel eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3003","description":"Foot insert silicone gel eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF1","description":"ICD-JHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83521","description":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE1","description":"ICD-CBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL31","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63047","description":"Remove spine lamina 1 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE0","description":"ICD-KEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA0","description":"ICD-GCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB0","description":"ICD-MDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31237","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ptrsn no gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9229","description":"Ptrsn no gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE0","description":"ICD-CIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC11","description":"ICD-2BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8F","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB0","description":"ICD-IITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA1","description":"ICD-NDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC1","description":"ICD-EHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF0","description":"ICD-BHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA0","description":"ICD-HESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chloramphenicol sodium injec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0720","description":"Chloramphenicol sodium injec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF0","description":"ICD-JEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA1","description":"ICD-BCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB1","description":"ICD-MDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE1","description":"ICD-BHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF1","description":"ICD-BHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB0","description":"ICD-JIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC0","description":"ICD-NBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD0","description":"ICD-GFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32480","description":"Partial removal of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE1","description":"ICD-NABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9753","description":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB1","description":"ICD-AIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD0","description":"ICD-NDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE0","description":"ICD-BCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ic lbw inf < 1500 gm subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99478","description":"Ic lbw inf < 1500 gm subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg cerebral death only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95824","description":"Eeg cerebral death only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8H","description":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0697T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF0","description":"ICD-OKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7353","description":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD1","description":"ICD-BHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA0","description":"ICD-KCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA1","description":"ICD-NJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC0","description":"ICD-NDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE1","description":"ICD-CIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB0","description":"ICD-AGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB0","description":"ICD-FBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA1","description":"ICD-CEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA1","description":"ICD-CBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE0","description":"ICD-EITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC212","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC1","description":"ICD-FHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8E","description":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF0","description":"ICD-JDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD1","description":"ICD-LBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA0","description":"ICD-KHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE1","description":"ICD-CHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81352","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD0","description":"ICD-OFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF0","description":"ICD-NHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF0","description":"ICD-OBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate sz 15-30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383T","description":"Ext h rate sz 15-30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID0","description":"ICD-KEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF1","description":"ICD-AIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC0","description":"ICD-KGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percut thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36870","description":"Percut thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF0","description":"ICD-LAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE0","description":"ICD-EBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE1","description":"ICD-CHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX35","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE0","description":"ICD-OLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21198","description":"Reconstr lwr jaw segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB1","description":"ICD-IHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF0","description":"ICD-KDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1203","description":"HCPCS-B1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobility current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8978","description":"Mobility current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC1","description":"ICD-KBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC0","description":"ICD-IALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42821","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0904","description":"HCPCS-C0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55650","description":"Remove sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11771","description":"Remove pilonidal cyst exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX25","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA0","description":"ICD-NKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytp urne 3-5 probes ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88120","description":"Cytp urne 3-5 probes ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE1","description":"ICD-NFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB1","description":"ICD-IABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61575","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC1","description":"ICD-IACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibiot not rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4124F","description":"Antibiot not rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC0","description":"ICD-OHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8B","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE1","description":"ICD-NAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of amylase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82150","description":"Assay of amylase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61698","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8005","description":"HCPCS-C8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE1","description":"ICD-NAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repos car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415T","description":"Repos car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cid ext speech process repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8627","description":"Cid ext speech process repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB1","description":"ICD-GCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB0","description":"ICD-CDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0A","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42600","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8D","description":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB1","description":"ICD-GGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2215","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD0","description":"ICD-IFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4A","description":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA1","description":"ICD-HCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21552","description":"Exc neck les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-covered item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9270","description":"Non-covered item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB1","description":"ICD-LBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB1","description":"ICD-MKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8020","description":"Limited dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD1","description":"ICD-NBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF0","description":"ICD-BGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD1","description":"ICD-NIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE1","description":"ICD-NDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB1","description":"ICD-OHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB0","description":"ICD-KBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB0","description":"ICD-NGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF0","description":"ICD-EBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE1","description":"ICD-GGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF1","description":"ICD-NAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB1","description":"ICD-MGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582T","description":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA0","description":"ICD-AHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38305","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate liver cryosurg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47371","description":"Laparo ablate liver cryosurg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1272","description":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen supplies regulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1353","description":"Oxygen supplies regulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Musc test done w/n test comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95886","description":"Musc test done w/n test comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE1","description":"ICD-BHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA1","description":"ICD-GBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE0","description":"ICD-JDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA1","description":"ICD-EHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE1","description":"ICD-JDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD0","description":"ICD-CIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen class list a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80301","description":"Drug screen class list a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA0","description":"ICD-KAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE1","description":"ICD-MIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB0","description":"ICD-CFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0675","description":"HCPCS-G0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic vein harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33508","description":"Endoscopic vein harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID1","description":"ICD-EHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral solution hepatic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5100","description":"Parenteral solution hepatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE1","description":"ICD-IFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9760","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Verify pt site pxd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6100F","description":"Verify pt site pxd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE1","description":"ICD-JELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD0","description":"ICD-GCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB1","description":"ICD-CATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE0","description":"ICD-CBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23515","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF0","description":"ICD-DGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA0","description":"ICD-OFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB0","description":"ICD-GDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77090","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot add charge split s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3257","description":"Orth foot add charge split s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB0","description":"ICD-MAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99305","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth ear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12451","description":"Anesth ear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ socket shoulder di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6689","description":"Frame typ socket shoulder di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF0","description":"ICD-NJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51590","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0938T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","description":"CPT-0938T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC0","description":"ICD-EDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE1","description":"ICD-MDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF0","description":"ICD-IEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topographic brain mapping","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8040","description":"Topographic brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD220","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA0","description":"ICD-NHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheal suction tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4624","description":"Tracheal suction tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bls defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0384","description":"Bls defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF0","description":"ICD-NGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD1","description":"ICD-DBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC1","description":"ICD-NLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6243","description":"Pontic - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE0","description":"ICD-IDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision gum each quadrant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41820","description":"Excision gum each quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE0","description":"ICD-BFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF0","description":"ICD-CFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD1","description":"ICD-OKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE0","description":"ICD-OCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17107","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD0","description":"ICD-FIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD1","description":"ICD-KGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC1","description":"ICD-CHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE146","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME1","description":"ICD-EDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantable tissue marker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4648","description":"Implantable tissue marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Basiliximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0480","description":"Basiliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot c activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85303","description":"Clot inhibit prot c activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC0","description":"ICD-NGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0820T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr stand fxd arm ft rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1130","description":"Whlchr stand fxd arm ft rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE1","description":"ICD-BINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE0","description":"ICD-JADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ margetuximab-cmkb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9353","description":"Injection_ margetuximab-cmkb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11971","description":"Remove tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5171","description":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Architect ecm px fx 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4147","description":"Architect ecm px fx 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD0","description":"ICD-OAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ventral hern init reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49560","description":"Rpr ventral hern init reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC1","description":"ICD-GFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csf shunt reprogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62252","description":"Csf shunt reprogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD1","description":"ICD-JADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5658","description":"Socket insert above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX56","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL05","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate mets no cast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9132","description":"Onc dx prostate mets no cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8902","description":"Mra w/o fol w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create new tubal opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58770","description":"Create new tubal opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD0","description":"ICD-BABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD105","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC1","description":"ICD-MILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC1","description":"ICD-MHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF1","description":"ICD-BILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36823","description":"Insertion of cannula(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA0","description":"ICD-PDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0368","description":"Cone beam ct interprete tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81438","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA1","description":"ICD-NKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC1","description":"ICD-OGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA0","description":"ICD-KBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB0","description":"ICD-NKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE0","description":"ICD-BCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD0","description":"ICD-KHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB1","description":"ICD-MDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0625T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant total heart system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051T","description":"Implant total heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aminocaproic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0017","description":"Injection_ aminocaproic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF1","description":"ICD-KCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64716","description":"Revision of cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0485U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","description":"CPT-0485U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64790","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC1","description":"ICD-MFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99140","description":"Emergency anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0103","description":"HCPCS-A0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB1","description":"ICD-BBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA1","description":"ICD-JABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0531U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","description":"CPT-0531U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF0","description":"ICD-JHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434U","description":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF1","description":"ICD-OCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csf shunt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78645","description":"Csf shunt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA1","description":"ICD-GIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB1","description":"ICD-IFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD0","description":"ICD-DIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg digital analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95957","description":"Eeg digital analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-rad contrast materialnoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9698","description":"Non-rad contrast materialnoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC254","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33917","description":"Repair pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scintimammography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8080","description":"Scintimammography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA0","description":"ICD-AHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA1","description":"ICD-OKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE0","description":"ICD-FCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB0","description":"ICD-NCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB1","description":"ICD-CGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA1","description":"ICD-LCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73650","description":"X-ray exam of heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB0","description":"ICD-OCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF0","description":"ICD-JETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF1","description":"ICD-GEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD1","description":"ICD-PARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc death after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9256","description":"Doc death after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64417","description":"N block inj axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC211","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2405","description":"Ondansetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB10","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","description":"CPT-01810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE1","description":"ICD-NDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sio flex pelvic/sacr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0621","description":"Sio flex pelvic/sacr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9717","description":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB0","description":"ICD-OIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA1","description":"ICD-CHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin pump initiation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9145","description":"Insulin pump initiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC0","description":"ICD-CCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE0","description":"ICD-JIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC0","description":"ICD-GHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC1","description":"ICD-PDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC0","description":"ICD-BGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40702","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE1","description":"ICD-KGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA0","description":"ICD-KEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF0","description":"ICD-BCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB0","description":"ICD-GIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88143","description":"Cytopath c/v thin layer redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC1","description":"ICD-NAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB201","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB1","description":"ICD-GIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB1","description":"ICD-KDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE0","description":"ICD-ICUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC0","description":"ICD-OERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75966","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC1","description":"ICD-CHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9257","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31603","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB0","description":"ICD-BCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE1","description":"ICD-NAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF1","description":"ICD-DHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limb nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64783","description":"Limb nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA1","description":"ICD-KIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE150","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho bi thighcuffs w sprdr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1652","description":"Ho bi thighcuffs w sprdr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC0","description":"ICD-OJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64905","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE1","description":"ICD-JFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA1","description":"ICD-CAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC0","description":"ICD-CEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA1","description":"ICD-HIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF0","description":"ICD-KITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99401","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin pheno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82104","description":"Alpha-1-antitrypsin pheno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD0","description":"ICD-OKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC0","description":"ICD-NAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF0","description":"ICD-FCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC156","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC1","description":"ICD-CIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF1","description":"ICD-KAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75716","description":"Artery x-rays arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB1","description":"ICD-OBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE1","description":"ICD-JAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA1","description":"ICD-CCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metl 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2530","description":"Dental inlay metl 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA44","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF1","description":"ICD-NJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt card prev msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9673","description":"Intend rpt card prev msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bat clps elec/comb vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0497","description":"Bat clps elec/comb vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE1","description":"ICD-KHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA1","description":"ICD-CCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95976","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27284","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/o brdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6211","description":"Foam drg > 48 sq in w/o brdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB21","description":"ICD-3AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15276","description":"Skin sub graft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA1","description":"ICD-PCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD0","description":"ICD-CIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE1","description":"ICD-JFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC0","description":"ICD-JCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE0","description":"ICD-KBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD0","description":"ICD-GAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD0","description":"ICD-EALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF1","description":"ICD-CCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8B","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic implnt urinary 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8606","description":"Synthetic implnt urinary 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pontic titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6214","description":"Pontic titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diag bronchoscope/catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31643","description":"Diag bronchoscope/catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0952T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","description":"CPT-0952T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE0","description":"ICD-NJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB1","description":"ICD-NKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE136","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alveoplasty w/ extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7310","description":"Alveoplasty w/ extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Folding ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1236","description":"Folding ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE110","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF0","description":"ICD-GBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0511","description":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED0","description":"ICD-MGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2007","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009M","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB1","description":"ICD-BIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB0","description":"ICD-FCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD1","description":"ICD-GFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC0","description":"ICD-EGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD0","description":"ICD-JGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE1","description":"ICD-IIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB0","description":"ICD-BGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE0","description":"ICD-EFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen probe used w oximeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4606","description":"Oxygen probe used w oximeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC260","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF0","description":"ICD-FCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC1","description":"ICD-IGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF0","description":"ICD-KDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No xray/ct/ et al ordd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3320F","description":"No xray/ct/ et al ordd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral talus autogrft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28446","description":"Osteochondral talus autogrft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB1","description":"ICD-GGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE1","description":"ICD-LESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA1","description":"ICD-EICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD1","description":"ICD-GIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC0","description":"ICD-HBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniocentesis diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59000","description":"Amniocentesis diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD1","description":"ICD-OJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD0","description":"ICD-PLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC211","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID1","description":"ICD-GBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28825","description":"Partial amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD0","description":"ICD-OEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD0","description":"ICD-OGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF0","description":"ICD-BCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35903","description":"Excision graft extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD0","description":"ICD-CHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE0","description":"ICD-NGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone response","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80414","description":"Testosterone response","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fb rmvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29904","description":"Subtalar arthro w/fb rmvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE0","description":"ICD-PIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place rt device/marker pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55876","description":"Place rt device/marker pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE0","description":"ICD-JICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED1","description":"ICD-ADED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA0","description":"ICD-OJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bp sys>=140 and/or dias >=90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8477","description":"Bp sys>=140 and/or dias >=90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92623","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body jacket mold to patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1300","description":"Body jacket mold to patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD0","description":"ICD-KHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE0","description":"ICD-OJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF0","description":"ICD-NCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA250","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB0","description":"ICD-OIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF1","description":"ICD-EHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33770","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF1","description":"ICD-OIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB0","description":"ICD-OBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB0","description":"ICD-OKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0808","description":"Pov group 2 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Max ultrasound capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0370","description":"Max ultrasound capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC1","description":"ICD-OBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analysis of saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0418","description":"Analysis of saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF0","description":"ICD-JIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA1","description":"ICD-OFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5899","description":"Removable prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD1","description":"ICD-OBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA1","description":"ICD-CFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE0","description":"ICD-MHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE0","description":"ICD-PARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF0","description":"ICD-NLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC0","description":"ICD-CFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF1","description":"ICD-FCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17281","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF1","description":"ICD-ODHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA1","description":"ICD-ADMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80307","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD151","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD0","description":"ICD-JGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA1","description":"ICD-EEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE0","description":"ICD-EIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC154","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE0","description":"ICD-NBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB201","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA0","description":"ICD-JFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35363","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC1","description":"ICD-DDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0746T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA0","description":"ICD-CDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9141","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD1","description":"ICD-KBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB0","description":"ICD-PFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emr hd pmp elec/combo_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0494","description":"Emr hd pmp elec/combo_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF0","description":"ICD-KGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2981","description":"Inlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta pres or already taking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9189","description":"Beta pres or already taking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aor/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35526","description":"Art byp grft aor/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB1","description":"ICD-CDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5271","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deli/install chrg hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1600","description":"Deli/install chrg hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD0","description":"ICD-OKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upgrade of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33214","description":"Upgrade of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC0","description":"ICD-FGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glasses cros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5190","description":"Glasses cros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto impl 4 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9740","description":"Cysto impl 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES141","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag-co shell pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0651","description":"Lso sag-co shell pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1301","description":"HCPCS-C1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos macroalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3062F","description":"Pos macroalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD0","description":"ICD-OHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj plantar digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64455","description":"N block inj plantar digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB1","description":"ICD-FIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME0","description":"ICD-BCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oasis burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4103","description":"Oasis burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA0","description":"ICD-OIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA0","description":"ICD-NINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam si joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72200","description":"X-ray exam si joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF0","description":"ICD-OKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 5 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95134","description":"Immntx 5 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30120","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB1","description":"ICD-MCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA0","description":"ICD-CAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1074","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE1","description":"ICD-MFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analysis nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88356","description":"Analysis nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26390","description":"Revise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE1","description":"ICD-FDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intervene hlth/behave group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96153","description":"Intervene hlth/behave group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB0","description":"ICD-BAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD0","description":"ICD-NBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC224","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD0","description":"ICD-IACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB0","description":"ICD-OLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m succimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9551","description":"Tc99m succimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF1","description":"ICD-CIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB0","description":"ICD-CCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0877T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME0","description":"ICD-JCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doppler color flow add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93325","description":"Doppler color flow add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC1","description":"ICD-OIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC0","description":"ICD-DFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE0","description":"ICD-IBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE0","description":"ICD-NHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF1","description":"ICD-JGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy retro balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43213","description":"Esophagoscopy retro balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0523U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","description":"CPT-0523U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intrvl 3/>yr pts clnscp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529F","description":"Intrvl 3/>yr pts clnscp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF1","description":"ICD-NHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD0","description":"ICD-DEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haptoglobins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83012","description":"Assay of haptoglobins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC0","description":"ICD-JCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF0","description":"ICD-CFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC1","description":"ICD-AFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43760","description":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA1","description":"ICD-IDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87251","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc 1st vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37184","description":"Prim art m-thrmbc 1st vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not receive cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9807","description":"Patients who did not receive cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37277","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","description":"CPT-37277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65815","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB106","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE1","description":"ICD-JCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME1","description":"ICD-IDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0762T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB0","description":"ICD-NBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome count additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88285","description":"Chromosome count additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mycophenolate mofetil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7519","description":"Injection_ mycophenolate mofetil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA0","description":"ICD-GEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26357","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1108","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB0","description":"ICD-IEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX07","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB1","description":"ICD-HEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD1","description":"ICD-CAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB1","description":"ICD-FFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold sock suspension t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6110","description":"Elbow mold sock suspension t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME1","description":"ICD-FDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE0","description":"ICD-IEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC0","description":"ICD-BFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","description":"HCPCS-M1410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED0","description":"ICD-AEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF1","description":"ICD-BBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB1","description":"ICD-CFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD121","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB0","description":"ICD-NLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr setup","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0607T","description":"Rem mntr pulm flu mntr setup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB0","description":"ICD-IDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair hallux rigidus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28289","description":"Repair hallux rigidus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53000","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB1","description":"ICD-OAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE1","description":"ICD-CCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD1","description":"ICD-AIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove muti-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54406","description":"Remove muti-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA0","description":"ICD-OLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asthma symptoms evaluate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1005F","description":"Asthma symptoms evaluate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D8091","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8091","description":"CDT-D8091","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1A","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF1","description":"ICD-EIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC1","description":"ICD-EEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0517","description":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services utilized by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9694","description":"Hospice services utilized by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB1","description":"ICD-KDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD1","description":"ICD-ODBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on external_ middle_ and inner ear including biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0117U","description":"Anesthesia for procedures on external_ middle_ and inner ear including biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2075","description":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML41","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0001","description":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC1","description":"ICD-JDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"H pylori drug admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83014","description":"H pylori drug admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasma fresh frozen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86927","description":"Plasma fresh frozen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46050","description":"Incision of anal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD1","description":"ICD-EDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC0","description":"ICD-AFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfusion service fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36460","description":"Transfusion service fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE1","description":"ICD-CDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human ig sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90284","description":"Human ig sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB0","description":"ICD-IEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE0","description":"ICD-FIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph endoscopy dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43226","description":"Esoph endoscopy dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE216","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of artery/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35761","description":"Exploration of artery/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4172F","description":"Pt not rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8662","description":"Fun stat score ls not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD0","description":"ICD-CCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE1","description":"ICD-JATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24685","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE1","description":"ICD-NCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB1","description":"ICD-OIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9746","description":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99466","description":"Ped crit care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC32","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Islet cell tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2102","description":"Islet cell tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB1","description":"ICD-JGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2114","description":"Afo tib fx semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96931","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0711","description":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto interm peritoneal dialy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1592","description":"Auto interm peritoneal dialy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC0","description":"ICD-GGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC0","description":"ICD-MLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE1","description":"ICD-EFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8914","description":"Mra w/o fol w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB1","description":"ICD-BBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16071","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16071","description":"CPT-16071","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC114","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB0","description":"ICD-PCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB0","description":"ICD-CASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA0","description":"ICD-JCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Omeza Collagen Matrix_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2014","description":"Omeza Collagen Matrix_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain appendix abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44900","description":"Drain appendix abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA46","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87420","description":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC0","description":"ICD-EEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/ureteral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50329","description":"Prep renal graft/ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic implant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8699","description":"Prosthetic implant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC1","description":"ICD-NAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC1","description":"ICD-OHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA1","description":"ICD-JECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41007","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA0","description":"ICD-KAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB1","description":"ICD-KAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES344","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt lumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221T","description":"Plmt post facet implt lumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate suspnsion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9217","description":"Leuprolide acetate suspnsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8E","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA0","description":"ICD-GDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA0","description":"ICD-NJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD0","description":"ICD-FDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Financial mgt waiver/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2040","description":"Financial mgt waiver/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC1","description":"ICD-GGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB0","description":"ICD-NBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF1","description":"ICD-OBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB0","description":"ICD-CCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED1","description":"ICD-OEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee disart_ sach ft_ endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5312","description":"Knee disart_ sach ft_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB0","description":"ICD-KGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC0","description":"ICD-CBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE1","description":"ICD-EALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA1","description":"ICD-KGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB1","description":"ICD-EEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB0","description":"ICD-NIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0881","description":"Darbepoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF1","description":"ICD-KCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB1","description":"ICD-KFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA0","description":"ICD-JGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB1","description":"ICD-DAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD0","description":"ICD-OHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leukacyte transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86950","description":"Leukacyte transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC0","description":"ICD-MIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Malig tumor > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7441","description":"Malig tumor > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA1","description":"ICD-JAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anthrax vaccine sc or im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90581","description":"Anthrax vaccine sc or im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD0","description":"ICD-JDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF0","description":"ICD-JHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67420","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF0","description":"ICD-OGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF0","description":"ICD-JEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE1","description":"ICD-JIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26040","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA1","description":"ICD-BHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB11","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag-coronal panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0638","description":"Lso sag-coronal panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE1","description":"ICD-OKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC1","description":"ICD-ODIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ >= 1.66 p/>=1.80 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2783","description":"Lens_ >= 1.66 p/>=1.80 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE0","description":"ICD-KDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE1","description":"ICD-LCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE1","description":"ICD-BEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29892","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF1","description":"ICD-NKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Outside state ambulance serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0021","description":"Outside state ambulance serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF0","description":"ICD-ODWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE0","description":"ICD-KCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF1","description":"ICD-KAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67346","description":"Biopsy eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD1","description":"ICD-GEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB0","description":"ICD-CGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID1","description":"ICD-CCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA0","description":"ICD-AGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA1","description":"ICD-OFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1004","description":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF1","description":"ICD-OFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA1","description":"ICD-KHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epifix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4186","description":"Epifix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE1","description":"ICD-GACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB1","description":"ICD-NDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC0","description":"ICD-KAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","description":"HCPCS-M1463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewho cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3961","description":"Sewho cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC0","description":"ICD-KHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic device repair rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7510","description":"Prosthetic device repair rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF1","description":"ICD-GDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDer B_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2016","description":"PermeaDer B_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE1","description":"ICD-KIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC1","description":"ICD-NJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4032","description":"Rheumatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA1","description":"ICD-CGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29856","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF0","description":"ICD-KCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98006","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","description":"CPT-98006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF0","description":"ICD-LBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA0","description":"ICD-BHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE1","description":"ICD-GAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC1","description":"ICD-GFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF0","description":"ICD-NKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF1","description":"ICD-GDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE1","description":"ICD-OFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE0","description":"ICD-KAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54316","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC0","description":"ICD-MBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB0","description":"ICD-GFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27151","description":"Incision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20250","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF0","description":"ICD-PFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB1","description":"ICD-KEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27122","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0862T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD0","description":"ICD-JEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2008","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA1","description":"ICD-OIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","description":"HCPCS-M1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE1","description":"ICD-OLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99285","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","description":"HCPCS-M0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit contac lens for managmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92072","description":"Fit contac lens for managmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE1","description":"ICD-BBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86051","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath intracranial art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36228","description":"Place cath intracranial art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27691","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD0","description":"ICD-BDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5274","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF0","description":"ICD-KFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pentamidine comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7676","description":"Pentamidine comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented and no reason is given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1314","description":"Bmi not documented and no reason is given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD1","description":"ICD-GBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9923","description":"Safety concerns screen provided and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cognitive skills development","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97532","description":"Cognitive skills development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder tumor surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91251","description":"Anesth bladder tumor surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD0","description":"ICD-MIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF1","description":"ICD-GFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD1","description":"ICD-GAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC0","description":"ICD-EBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compl zift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4014","description":"Compl zift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB0","description":"ICD-CIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC0","description":"ICD-NDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC0","description":"ICD-CFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA1","description":"ICD-NKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB0","description":"ICD-CGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7608","description":"Acetylcysteine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE0","description":"ICD-FDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening pap smear by phys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3001","description":"Screening pap smear by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA0","description":"ICD-MDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA1","description":"ICD-HHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF1","description":"ICD-KFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA141","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0916T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","description":"CPT-0916T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25525","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124U","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD0","description":"ICD-PCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spirometry up to 2 yrs old","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94011","description":"Spirometry up to 2 yrs old","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1216","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00211","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","description":"CPT-00211","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66940","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","description":"CPT-01272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bio-connekt per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4161","description":"Bio-connekt per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB1","description":"ICD-CCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF1","description":"ICD-IALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87899","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC0","description":"ICD-KBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58260","description":"Vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_ bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8906","description":"MRI w/cont_ breast_ bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5992","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","description":"HCPCS-L5992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Swivel adaptor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8186","description":"Swivel adaptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6950","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA0","description":"ICD-EBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81232","description":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD1","description":"ICD-OHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2177","description":"Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE0","description":"ICD-OLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cold agglutinin screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86156","description":"Cold agglutinin screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF0","description":"ICD-EGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE1","description":"ICD-MBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD1","description":"ICD-FGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fractionation ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83593","description":"Fractionation ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB0","description":"ICD-FAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE255","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD0","description":"ICD-DGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE1","description":"ICD-ABBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF0","description":"ICD-FEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB1","description":"ICD-KAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/subs interv >30 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0397","description":"Alcohol/subs interv >30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way silcne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4315","description":"Cath w/drainage 2-way silcne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD0","description":"ICD-FBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE1","description":"ICD-CIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of paste boot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29580","description":"Application of paste boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrigation set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4400","description":"Ostomy irrigation set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytherapy radioelements","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3001","description":"Brachytherapy radioelements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk waist belt padded and lin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5690","description":"Bk waist belt padded and lin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC0","description":"ICD-FDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF0","description":"ICD-OIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB0","description":"ICD-IBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF1","description":"ICD-AGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair clitoris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56805","description":"Repair clitoris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE0","description":"ICD-GCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2009","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim unattend for press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0281","description":"Elec stim unattend for press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE1","description":"ICD-BDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meg evoked each addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95967","description":"Meg evoked each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA1","description":"ICD-BHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy 2/> injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95125","description":"Immunotherapy 2/> injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9799","description":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF0","description":"ICD-FIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC1","description":"ICD-MCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE1","description":"ICD-FIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyto/molecular report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88291","description":"Cyto/molecular report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC1","description":"ICD-BCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect radius tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24152","description":"Resect radius tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX30","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE0","description":"ICD-JBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD1","description":"ICD-NLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket hip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5702","description":"Replace socket hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8909","description":"Pt doc no burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB1","description":"ICD-GHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm isolation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89261","description":"Sperm isolation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC0","description":"ICD-CDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC0","description":"ICD-GBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB1","description":"ICD-PJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51030","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC0","description":"ICD-CBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95709","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA0","description":"ICD-CGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE1","description":"ICD-KGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 2 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34842","description":"Endovasc visc aorta 2 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admit w/in 180d req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9412","description":"Admit w/in 180d req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0612U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","description":"CPT-0612U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF0","description":"ICD-GGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE0","description":"ICD-PCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA0","description":"ICD-JHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB1","description":"ICD-KGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA0","description":"ICD-GHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert idrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63304","description":"Remove vert idrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4008","description":"Cast sup long arm ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mifepristone_ oral_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0190","description":"Mifepristone_ oral_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95115","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF0","description":"ICD-AIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Galectin-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82777","description":"Galectin-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB0","description":"ICD-GGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA1","description":"ICD-ICCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE1","description":"ICD-NLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01502","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","description":"CPT-01502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiemetic drug oral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8597","description":"Antiemetic drug oral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC1","description":"ICD-OGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD1","description":"ICD-GGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure reading not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1281","description":"Blood pressure reading not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59857","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD0","description":"ICD-FGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2522","description":"Cntct lens hydrophil bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7520","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD0","description":"ICD-GCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72069","description":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC1","description":"ICD-OKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney/ureter surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86251","description":"Anesth kidney/ureter surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF1","description":"ICD-OBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD1","description":"ICD-KGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21407","description":"Opn tx orbit fx w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9839","description":"Anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA0","description":"ICD-CALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC1","description":"ICD-EAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE251","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD0","description":"ICD-LFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB0","description":"ICD-JGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA251","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB0","description":"ICD-JBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD0","description":"ICD-NJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB0","description":"ICD-OFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70130","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE0","description":"ICD-DDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA0","description":"ICD-IAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperi needle place pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55875","description":"Transperi needle place pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier supplemental w/ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0560","description":"Humidifier supplemental w/ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87324","description":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tbo-filgrastim_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1446","description":"Injection_ tbo-filgrastim_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA1","description":"ICD-DHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cva lumen obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75902","description":"Remove cva lumen obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC0","description":"ICD-OGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb quant transcutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88738","description":"Hgb quant transcutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence garment anytype","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4520","description":"Incontinence garment anytype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1075","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Day habil waiver per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2021","description":"Day habil waiver per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Full length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4510","description":"Full length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC1","description":"ICD-KEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0869T","description":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd guide wire insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43248","description":"Egd guide wire insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24363","description":"Replace elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53446","description":"Remove uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom breast prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8035","description":"Custom breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD1","description":"ICD-GEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA1","description":"ICD-CBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42725","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35131","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA1","description":"ICD-GERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0814T","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD0","description":"ICD-NKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD0","description":"ICD-KIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC0","description":"ICD-JCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75945","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA0","description":"ICD-CGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE0","description":"ICD-NCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denosumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0897","description":"Denosumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone sodium phos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1100","description":"Dexamethasone sodium phos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin copper sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83026","description":"Hemoglobin copper sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1065T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1065T","description":"CPT-1065T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE0","description":"ICD-OAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD215","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB0","description":"ICD-CDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lsh uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58543","description":"Lsh uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lower jaw bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21215","description":"Lower jaw bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/joint(s) custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3806","description":"Whfo w/joint(s) custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0106","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0106","description":"CDT-D0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB0","description":"ICD-NAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA0","description":"ICD-CIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","description":"CPT-01274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109U","description":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC11","description":"ICD-4EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9810","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9810","description":"HCPCS-C9810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD145","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED1","description":"ICD-MBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF0","description":"ICD-NHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE1","description":"ICD-GBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC0","description":"ICD-KHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB11","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho abduction static plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1660","description":"Ho abduction static plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC1","description":"ICD-IDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1823","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF0","description":"ICD-GEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD1","description":"ICD-NBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB0","description":"ICD-CFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25355","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD0","description":"ICD-NAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0966T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","description":"CPT-0966T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19350","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8E","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screen mammo doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3014F","description":"Screen mammo doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD1","description":"ICD-KCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF0","description":"ICD-BAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF0","description":"ICD-OBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF1","description":"ICD-OBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF1","description":"ICD-FALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50240","description":"Partial removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF1","description":"ICD-OLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB33","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD260","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311T","description":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE0","description":"ICD-GAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF1","description":"ICD-IIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB0","description":"ICD-MIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90371","description":"Hep b ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semi-precision attachment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6192","description":"Semi-precision attachment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE1","description":"ICD-ODFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF1","description":"ICD-JFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA1","description":"ICD-KCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient glove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8427","description":"Ready gradient glove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF0","description":"ICD-BAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB216","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Locm 300-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9967","description":"Locm 300-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME1","description":"ICD-OJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8691","description":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA31","description":"ICD-2HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93985","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC0","description":"ICD-HFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0558T","description":"Computed tomography scan taken for the purpose of biomechanical computed tomography analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA21","description":"ICD-3JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB0","description":"ICD-JILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65091","description":"Revise eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB0","description":"ICD-CGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD211","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD1","description":"ICD-FAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl tip cane/crutch/walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4637","description":"Repl tip cane/crutch/walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA0","description":"ICD-CCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA1","description":"ICD-CHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB1","description":"ICD-GDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94851","description":"Anesth repair of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sugars multiple quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84379","description":"Sugars multiple quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex 2 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87273","description":"Herpes simplex 2 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral periapical ea add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0230","description":"Intraoral periapical ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC144","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81413","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF0","description":"ICD-NIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray/ct/ultrsnd et al ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3319F","description":"X-ray/ct/ultrsnd et al ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB1","description":"ICD-KIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0606","description":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB1","description":"ICD-BBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA1","description":"ICD-FFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB1","description":"ICD-NJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19120","description":"Removal of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC1","description":"ICD-KDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathologists/dermatopathologists providing a second opinion on a biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9784","description":"Pathologists/dermatopathologists providing a second opinion on a biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF1","description":"ICD-MIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9325","description":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61567","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 4999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4725","description":"Dialys sol fld vol > 4999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE0","description":"ICD-OBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fecal fat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82715","description":"Assay of fecal fat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE1","description":"ICD-LIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2C","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB0","description":"ICD-PISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF1","description":"ICD-BGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC0","description":"ICD-BDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID0","description":"ICD-IEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA17","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28505","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE144","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20982","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB12","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv no prsv increased ag im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90662","description":"Iiv no prsv increased ag im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF1","description":"ICD-NEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9769","description":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB11","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB115","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD0","description":"ICD-OFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC0","description":"ICD-KBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96366","description":"Ther/proph/diag iv inf addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6753","description":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0490","description":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icg angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92240","description":"Icg angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17262","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD1","description":"ICD-DDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1150F","description":"Doc pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advancing rheumatology patient care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0053","description":"Advancing rheumatology patient care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable ext urethral dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4360","description":"Disposable ext urethral dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA21","description":"ICD-3DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE0","description":"ICD-KARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB0","description":"ICD-AFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE1","description":"ICD-FAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA1","description":"ICD-AFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME1","description":"ICD-KAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra/penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54352","description":"Reconstruct urethra/penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0202","description":"HCPCS-A0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ fixed_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1893","description":"Intro/sheath_ fixed_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA0","description":"ICD-KEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86941","description":"Hemolysins/agglutinins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us nuchal meas 1 gest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76813","description":"Ob us nuchal meas 1 gest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE0","description":"ICD-NIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB1","description":"ICD-JBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF1","description":"ICD-JAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27742","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rotary wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0431","description":"Rotary wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA1","description":"ICD-AITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE1","description":"ICD-GHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6066","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE0","description":"ICD-CDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE1","description":"ICD-MHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML11","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC0","description":"ICD-DDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF1","description":"ICD-IDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB0","description":"ICD-GHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2955","description":"Post removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38564","description":"Removal abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB0","description":"ICD-GINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME0","description":"ICD-MBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF0","description":"ICD-NGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98968","description":"Hc pro phone call 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA0","description":"ICD-MCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD0","description":"ICD-FIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF1","description":"ICD-OKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrned for inj drug use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4290F","description":"Pt scrned for inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE1","description":"ICD-BFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC1","description":"ICD-NDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35011","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pneum swg frct exo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5722","description":"Knee-shin pneum swg frct exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD1","description":"ICD-JILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of renin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84244","description":"Assay of renin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE1","description":"ICD-CDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA0","description":"ICD-EHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73700","description":"Ct lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD0","description":"ICD-PEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB1","description":"ICD-FFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43510","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8564","description":"Pt ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD0","description":"ICD-MDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0447","description":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC0","description":"ICD-OKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC1","description":"ICD-MCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE1","description":"ICD-OJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0976T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","description":"CPT-0976T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD1","description":"ICD-JETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resp suction oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7047","description":"Resp suction oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC1","description":"ICD-DDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1904","description":"HCPCS-B1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supprelin la implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9226","description":"Supprelin la implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA1","description":"ICD-KHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB0","description":"ICD-FHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE0","description":"ICD-NDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3350","description":"Shoe heel wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5A","description":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0739T","description":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95930","description":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB1","description":"ICD-KIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26590","description":"Repair finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE1","description":"ICD-MKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC1","description":"ICD-GDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB0","description":"ICD-FIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB0","description":"ICD-OBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF0","description":"ICD-JIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64708","description":"Revise arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 4 visits p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90951","description":"Esrd serv 4 visits p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA0","description":"ICD-BFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC1","description":"ICD-OKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95144","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA1","description":"ICD-FIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB1","description":"ICD-KDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD1","description":"ICD-MDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9963","description":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22214","description":"Incis 1 vertebral seg lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone replacement graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7953","description":"Bone replacement graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE1","description":"ICD-DDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD1","description":"ICD-HHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red cell mass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78121","description":"Red cell mass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"U1nonsealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2364","description":"U1nonsealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8I","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA1","description":"ICD-GFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67938","description":"Remove eyelid foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66180","description":"Aqueous shunt eye w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo spine n generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63685","description":"Insrt/redo spine n generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND0","description":"ICD-NKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA0","description":"ICD-EHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB0","description":"ICD-NBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD256","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL21","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47785","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58575","description":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF1","description":"ICD-BFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28285","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX10","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB1","description":"ICD-FBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE245","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA1","description":"ICD-EFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34421","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE0","description":"ICD-OLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resin retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6549","description":"Resin retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA1","description":"ICD-KETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cane adjust/fixed quad/3 pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0105","description":"Cane adjust/fixed quad/3 pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64650","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0802","description":"HCPCS-A0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD1","description":"ICD-JHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC0","description":"ICD-MKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE1","description":"ICD-CHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 21-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99448","description":"Interprof phone/online 21-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB1","description":"ICD-GIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD0","description":"ICD-ICDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alarm symp assessed-1+ prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1071F","description":"Alarm symp assessed-1+ prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC0","description":"ICD-JEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC0","description":"ICD-AFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD1","description":"ICD-OHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD0","description":"ICD-JEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6559","description":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC135","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB150","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8931","description":"Mra_ w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE0","description":"ICD-BBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec site no cutaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9430","description":"Spec site no cutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Latex leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5113","description":"Latex leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF0","description":"ICD-JIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA1","description":"ICD-CDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ conivaptan hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9488","description":"Injection_ conivaptan hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB1","description":"ICD-KHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental house call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9410","description":"Dental house call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99310","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0834T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID1","description":"ICD-AGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB1","description":"ICD-KEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exchange lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66986","description":"Exchange lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33509","description":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA0","description":"ICD-FENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD134","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0259U","description":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA0","description":"ICD-ADIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_maintenance rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9002","description":"Mccd_maintenance rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc chronic 1vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92943","description":"Prq card revasc chronic 1vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD1","description":"ICD-GHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA245","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision subvalvular tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33415","description":"Revision subvalvular tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC0","description":"ICD-CDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE1","description":"ICD-IHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD0","description":"ICD-NIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA1","description":"ICD-LDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC1","description":"ICD-OHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27756","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88299","description":"Cytogenetic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB1","description":"ICD-DHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2023F","description":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD1","description":"ICD-FIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF0","description":"ICD-CICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1079T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1079T","description":"CPT-1079T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA0","description":"ICD-OGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB260","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD1","description":"ICD-KCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB0","description":"ICD-NHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB1","description":"ICD-NKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal pillows","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7033","description":"Replacement nasal pillows","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD0","description":"ICD-AFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33221","description":"Insert pulse gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE0","description":"ICD-GISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD0","description":"ICD-EBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20220","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE1","description":"ICD-JCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD0","description":"ICD-KFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile_ gloves per pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4930","description":"Sterile_ gloves per pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiology port images(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77417","description":"Radiology port images(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88104","description":"Cytopath fl nongyn smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93930","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haloperidol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80173","description":"Assay of haloperidol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA1","description":"ICD-BANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9900","description":"Supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF0","description":"ICD-OATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Agalsidase beta injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0180","description":"Agalsidase beta injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","description":"CPT-93145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte culture mixed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86821","description":"Lymphocyte culture mixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC0","description":"ICD-CCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF1","description":"ICD-GAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cstm dme other than wheelchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0900","description":"Cstm dme other than wheelchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE1","description":"ICD-ACBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD204","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC1","description":"ICD-JGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69554","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo radical nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50545","description":"Laparo radical nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC0","description":"ICD-EHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF1","description":"ICD-CANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF1","description":"ICD-GGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF1","description":"ICD-OLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Free assay (ft-3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84481","description":"Free assay (ft-3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig bmi calculation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8422","description":"Pt inelig bmi calculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA0","description":"ICD-JGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3031","description":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF1","description":"ICD-CEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD1","description":"ICD-BCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF0","description":"ICD-CFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0639U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0639U","description":"CPT-0639U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB1","description":"ICD-NJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revoshield + amniotic barrier_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4289","description":"Revoshield + amniotic barrier_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Buttock fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27027","description":"Buttock fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399U","description":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF1","description":"ICD-CBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excursion amplifier lever ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6642","description":"Excursion amplifier lever ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE1","description":"ICD-IHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA1","description":"ICD-BIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC1","description":"ICD-OGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0090U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0D","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE0","description":"ICD-GIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF0","description":"ICD-GGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolong serv w/o contact add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99359","description":"Prolong serv w/o contact add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE0","description":"ICD-IITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0011","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED0","description":"ICD-OKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipid panel doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3011F","description":"Lipid panel doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine w/cath crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62318","description":"Inject spine w/cath crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rigid wheeled walker adj/fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0141","description":"Rigid wheeled walker adj/fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mt bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20957","description":"Mt bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF1","description":"ICD-EEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/abn lvef inelig b-bloc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8451","description":"Pt w/abn lvef inelig b-bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE0","description":"ICD-NABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB1","description":"ICD-JBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC1","description":"ICD-KDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE0","description":"ICD-CGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE1","description":"ICD-KDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8A","description":"Medium Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2136","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC1","description":"ICD-NHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB17","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ratchet assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0050","description":"Ratchet assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB0","description":"ICD-CCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC1","description":"ICD-PGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE0","description":"ICD-HHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF0","description":"ICD-GFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC01","description":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA1","description":"ICD-KCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intrinsic factor antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86340","description":"Intrinsic factor antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC0","description":"ICD-NDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA0","description":"ICD-JALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enamel microabrasion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9970","description":"Enamel microabrasion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB1","description":"ICD-OBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genet virus isolate hsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87255","description":"Genet virus isolate hsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC251","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF0","description":"ICD-NICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesion barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1765","description":"Adhesion barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB1","description":"ICD-FGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of amputation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24935","description":"Revision of amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB1","description":"ICD-NGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA0","description":"ICD-NHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB0","description":"ICD-DERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD0","description":"ICD-GIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA0","description":"ICD-OIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1249","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triptorelin pamoate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3315","description":"Triptorelin pamoate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dementia severity classified_ moderate (DEM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2033F","description":"Dementia severity classified_ moderate (DEM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF1","description":"ICD-OHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC205","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval on foot not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8415","description":"Eval on foot not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auric/peri pain assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1116F","description":"Auric/peri pain assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA1","description":"ICD-HCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Pembrolizumab_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9027","description":"Injection_ Pembrolizumab_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig lesion<=1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7413","description":"Excision malig lesion<=1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0765T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE0","description":"ICD-DBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD0","description":"ICD-PLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC0","description":"ICD-KFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6721","description":"Crown resin w/base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF1","description":"ICD-OFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA1","description":"ICD-GFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC0","description":"ICD-MELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE0","description":"ICD-NDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB1","description":"ICD-OCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB1","description":"ICD-CGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC0","description":"ICD-EFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA1","description":"ICD-FIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE1","description":"ICD-FAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion ball br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2090","description":"Hkafo unilat torsion ball br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF1","description":"ICD-BIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB1","description":"ICD-LGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF0","description":"ICD-CIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC0","description":"ICD-IICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0509U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509U","description":"CPT-0509U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA0","description":"ICD-BHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA0","description":"ICD-NEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA1","description":"ICD-CEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF0","description":"ICD-JFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA0","description":"ICD-CDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF0","description":"ICD-LCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE0","description":"ICD-OHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED1","description":"ICD-GDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB0","description":"ICD-GFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE0","description":"ICD-AACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA1","description":"ICD-NHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35560","description":"Art byp grft aortorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC1","description":"ICD-BGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA1","description":"ICD-MDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flex-walk sys low ext prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5981","description":"Flex-walk sys low ext prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME1","description":"ICD-GFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC0","description":"ICD-MEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef hydrolyzed/amino acids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4153","description":"Ef hydrolyzed/amino acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc skin abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15830","description":"Exc skin abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC1","description":"ICD-GCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD1","description":"ICD-NCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF1","description":"ICD-KDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Baseline mrs > 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1236","description":"Baseline mrs > 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1019","description":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE1","description":"ICD-NDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC1","description":"ICD-FDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD1","description":"ICD-KBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB0","description":"ICD-GBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD1","description":"ICD-OGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21139","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95977","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1148","description":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC0","description":"ICD-EIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD0","description":"ICD-BCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE1","description":"ICD-BDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA1","description":"ICD-GEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF0","description":"ICD-OJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD1","description":"ICD-HBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Athletic train eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97005","description":"Athletic train eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB0","description":"ICD-GDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB1","description":"ICD-OBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81551","description":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD1","description":"ICD-DHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE1","description":"ICD-FFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC1","description":"ICD-OHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46748","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE1","description":"ICD-OGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB1","description":"ICD-CHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB0","description":"ICD-FIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Moderate Or Severe Mitral Stenosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0044","description":"Patients With Moderate Or Severe Mitral Stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1162","description":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acne surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10040","description":"Acne surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD0","description":"ICD-FGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63086","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE0","description":"ICD-GFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC0","description":"ICD-KFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB1","description":"ICD-DERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm adult plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4005","description":"Cast sup long arm adult plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1303","description":"CDT-D1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Work hardening add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97546","description":"Work hardening add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD0","description":"ICD-OJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE1","description":"ICD-CBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61760","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26236","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF1","description":"ICD-KABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB131","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0933T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","description":"CPT-0933T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE0","description":"ICD-OGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD0","description":"ICD-DGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA1","description":"ICD-BBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD131","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12045","description":"Intmd rpr n-hf/genit12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF1","description":"ICD-PGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC1","description":"ICD-OLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC0","description":"ICD-JDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD0","description":"ICD-FCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF1","description":"ICD-OCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0736T","description":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB1","description":"ICD-BETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC1","description":"ICD-GHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC1","description":"ICD-NHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB0","description":"ICD-ODXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC0","description":"ICD-NIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA1","description":"ICD-JDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA1","description":"ICD-GFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD1","description":"ICD-PLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF1","description":"ICD-KALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj subclav carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35694","description":"Art trnsposj subclav carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD1","description":"ICD-PDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA1","description":"ICD-IGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0559T","description":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD0","description":"ICD-OABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF0","description":"ICD-CGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE1","description":"ICD-CAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB1","description":"ICD-EBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF1","description":"ICD-NFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat scapula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23585","description":"Treat scapula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408U","description":"Infectious agent antigen detection by bulk acoustic wave biosensor immunoassay_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","description":"CPT-01260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC0","description":"ICD-HHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE0","description":"ICD-NKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93590","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB1","description":"ICD-NHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB1","description":"ICD-NJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC1","description":"ICD-EDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1516","description":"Space maintainer_ fixed_ bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC1","description":"ICD-MKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB0","description":"ICD-BCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2121","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID0","description":"ICD-MDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-S4024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","description":"HCPCS-S4024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC1","description":"ICD-OFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE1","description":"ICD-AAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33864","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c wdth 24-27 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2341","description":"W/c wdth 24-27 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disease mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0317","description":"Disease mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF1","description":"ICD-CAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF0","description":"ICD-NBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB1","description":"ICD-CFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD0","description":"ICD-FDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD0","description":"ICD-CCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473U","description":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC1","description":"ICD-HARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2168","description":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA52","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA0","description":"ICD-OIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6012","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01991","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","description":"CPT-01991","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC1","description":"ICD-GAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE0","description":"ICD-CIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranial remolding orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1040","description":"Cranial remolding orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD0","description":"ICD-GGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove mesh from abd wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11008","description":"Remove mesh from abd wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA0","description":"ICD-ICEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB0","description":"ICD-EBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE0","description":"ICD-BGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD0","description":"ICD-LGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cognit impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3720F","description":"Cognit impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oliceridine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9101","description":"Injection_ oliceridine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD0","description":"ICD-IFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF0","description":"ICD-BEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE0","description":"ICD-BAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC1","description":"ICD-KIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","description":"HCPCS-Q4420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC1","description":"ICD-ADDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC1","description":"ICD-NANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA1","description":"ICD-MKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD1","description":"ICD-JABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA1","description":"ICD-BEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70120","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7552","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE1","description":"ICD-KDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA0","description":"ICD-LCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0607","description":"Repl batt for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE1","description":"ICD-CETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF1","description":"ICD-KGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB1","description":"ICD-MADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC1","description":"ICD-JECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt care icu&vent w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4168F","description":"Pt care icu&vent w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB0","description":"ICD-KITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA1","description":"ICD-OLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC1","description":"ICD-EDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC0","description":"ICD-MEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392U","description":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6624","description":"Inlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD1","description":"ICD-KAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25622","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain image w/flow < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78601","description":"Brain image w/flow < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD1","description":"ICD-ODKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA1","description":"ICD-GEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24940","description":"Revision of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA0","description":"ICD-FCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37227","description":"Fem/popl revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62005","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA0","description":"ICD-NFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC1","description":"ICD-OEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA0","description":"ICD-FAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA0","description":"ICD-GGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE1","description":"ICD-CAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD1","description":"ICD-GACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB0","description":"ICD-EILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82626","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting ramus closed","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7941","description":"Bone cutting ramus closed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC0","description":"ICD-AIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay carbamazepine free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80157","description":"Assay carbamazepine free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD1","description":"ICD-EBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB1","description":"ICD-NCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA1","description":"ICD-OBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA0","description":"ICD-CEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC0","description":"ICD-GEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX32","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA1","description":"ICD-JIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE1","description":"ICD-OJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD0","description":"ICD-FGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES113","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF1","description":"ICD-EATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24640","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toc tool incl elem not used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9658","description":"Toc tool incl elem not used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0805","description":"HCPCS-B0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB1","description":"ICD-BGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treprostinil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3285","description":"Treprostinil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091U","description":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF1","description":"ICD-CEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF1","description":"ICD-FCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF1","description":"ICD-MHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD1","description":"ICD-GDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Expired gas collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94250","description":"Expired gas collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE0","description":"ICD-LDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE0","description":"ICD-PLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftrst upper hanger bracket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0044","description":"Ftrst upper hanger bracket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF0","description":"ICD-MLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME0","description":"ICD-ODME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC0","description":"ICD-CAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX43","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/prst8 commissurotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0619T","description":"Cysto w/prst8 commissurotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot exam performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2028F","description":"Foot exam performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37241","description":"Vasc embolize/occlude venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat elevation sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2300","description":"Pwr seat elevation sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE1","description":"ICD-IICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE1","description":"ICD-NJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND0","description":"ICD-CDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2042","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","description":"HCPCS-A2042","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3260","description":"Tobramycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26125","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0D","description":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC0","description":"ICD-AAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB1","description":"ICD-BDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB1","description":"ICD-PIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB1","description":"ICD-NCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC1","description":"ICD-AECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA1","description":"ICD-OKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC0","description":"ICD-OBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82330","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC0","description":"ICD-LEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD1","description":"ICD-PJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0870","description":"Pwc gp 4 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF0","description":"ICD-DHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF1","description":"ICD-JAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC0","description":"ICD-CGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB1","description":"ICD-CEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx orbit w/manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21401","description":"Closed tx orbit w/manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF1","description":"ICD-KIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE101","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0060U","description":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":">85y no hx colo ca/rsn scope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9659","description":">85y no hx colo ca/rsn scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No antibio w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9287","description":"No antibio w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC0","description":"ICD-GBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE0","description":"ICD-ODHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61581","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE0","description":"ICD-KDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD1","description":"ICD-NLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess inc xray docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3340F","description":"Mammo assess inc xray docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power operated vehicle noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0812","description":"Power operated vehicle noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF0","description":"ICD-KERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA1","description":"ICD-ECCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53449","description":"Repair uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL03","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE0","description":"ICD-CHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs/chest4/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71111","description":"X-ray exam ribs/chest4/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD1","description":"ICD-CAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD0","description":"ICD-HAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID1","description":"ICD-CAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 2-3 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22808","description":"Ant fusion 2-3 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL36","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD1","description":"ICD-LIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy bowel pouch/biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44386","description":"Endoscopy bowel pouch/biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD1","description":"ICD-KBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB1","description":"ICD-GFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA0","description":"ICD-ICIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA1","description":"ICD-GEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65420","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF1","description":"ICD-IFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated hb home device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83037","description":"Glycosylated hb home device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","description":"HCPCS-M1435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD1","description":"ICD-KFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF1","description":"ICD-ICAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML17","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE0","description":"ICD-FFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC1","description":"ICD-OHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF0","description":"ICD-BIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB0","description":"ICD-IGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36483","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22222","description":"Incis w/discectomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC1","description":"ICD-CDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Demo-smoking cessation coun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9016","description":"Demo-smoking cessation coun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51600","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr/aicd combination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1899","description":"Lead_ pmkr/aicd combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF1","description":"ICD-CDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC1","description":"ICD-JFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA0","description":"ICD-CFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE0","description":"ICD-BHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6097","description":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0464","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD0","description":"ICD-JHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE0","description":"ICD-KGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test nonparaspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95870","description":"Muscle test nonparaspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50400","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart failure composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001F","description":"Heart failure composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC151","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD0","description":"ICD-JDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30450","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236U","description":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21137","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum/remove sigmoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45550","description":"Repair rectum/remove sigmoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA1","description":"ICD-BAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC1","description":"ICD-IITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare heart-aorta conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33404","description":"Prepare heart-aorta conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA1","description":"ICD-DEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC1","description":"ICD-BHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve addl insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31651","description":"Bronchial valve addl insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE0","description":"ICD-FHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19288","description":"Perq dev breast add mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1123","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA1","description":"ICD-GHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap myotomy heller","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43279","description":"Lap myotomy heller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81188","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC0","description":"ICD-NHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD1","description":"ICD-CFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24495","description":"Decompression of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA32","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME0","description":"ICD-MIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41017","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0666","description":"Pneumatic appliance half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA0","description":"ICD-DHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB1","description":"ICD-OHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA1","description":"ICD-NCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96167","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA1","description":"ICD-OJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9577","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2062","description":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove prostate regrowth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52630","description":"Remove prostate regrowth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1894","description":"Intro/sheath_ non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD0","description":"ICD-BHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA0","description":"ICD-NAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3671","description":"So cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME1","description":"ICD-GDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50395","description":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 2-3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73502","description":"X-ray exam hip uni 2-3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC1","description":"ICD-ICBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel new leather standa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3455","description":"Shoe heel new leather standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF0","description":"ICD-EEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent same","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37238","description":"Open/perq place stent same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref doc oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8559","description":"Pt ref doc oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME0","description":"ICD-NBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC0","description":"ICD-JIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular endoscopy procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37501","description":"Vascular endoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB0","description":"ICD-GFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA11","description":"ICD-3LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC1","description":"ICD-CBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD0","description":"ICD-DCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA0","description":"ICD-MILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC1","description":"ICD-JDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs cranial lesion complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61798","description":"Srs cranial lesion complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colectomy w/ileoanal anast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44157","description":"Colectomy w/ileoanal anast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC1","description":"ICD-CATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteot hum xtrnl lngth dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0594T","description":"Osteot hum xtrnl lngth dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6450","description":"Lt compres band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA156","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surg redct fibrous tuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7972","description":"Surg redct fibrous tuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE0","description":"ICD-OEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED1","description":"ICD-EHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF0","description":"ICD-MKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA0","description":"ICD-BFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF0","description":"ICD-FIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88367","description":"Insitu hybridization auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1213","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA1","description":"ICD-NEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC1","description":"ICD-GAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB0","description":"ICD-GANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1127","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD1","description":"ICD-LHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3999","description":"Endodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB0","description":"ICD-MAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mon cable elec/pneum vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0486","description":"Mon cable elec/pneum vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB1","description":"ICD-JIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32650","description":"Thoracoscopy w/pleurodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB1","description":"ICD-PIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject suprvlv aortography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93567","description":"Inject suprvlv aortography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB0","description":"ICD-NGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA0","description":"ICD-MBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB0","description":"ICD-KIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC1","description":"ICD-CDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD1","description":"ICD-CEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93313","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC0","description":"ICD-HFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of shoulder ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23415","description":"Release of shoulder ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF1","description":"ICD-NKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision/removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27424","description":"Revision/removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0425","description":"Inpt/ed teleconsult30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4259","description":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB0","description":"ICD-NIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43754","description":"Dx gastr intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC0","description":"ICD-JBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF0","description":"ICD-NBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF1","description":"ICD-PBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA0","description":"ICD-FDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88162","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD1","description":"ICD-BBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control hip heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2620","description":"Pelvic control hip heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD1","description":"ICD-ODSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73660","description":"X-ray exam of toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD0","description":"ICD-BBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE0","description":"ICD-FAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE1","description":"ICD-CBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA0","description":"ICD-IFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA0","description":"ICD-GGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91302","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD0","description":"ICD-NKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF1","description":"ICD-NLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aac non-electronic board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1902","description":"Aac non-electronic board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD0","description":"ICD-KBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD0","description":"ICD-ODWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA1","description":"ICD-NBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE0","description":"ICD-KFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj progesterone per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2675","description":"Inj progesterone per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate renal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50542","description":"Laparo ablate renal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA0","description":"ICD-NLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1013","description":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50580","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9877","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD0","description":"ICD-CDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF1","description":"ICD-JEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB114","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE1","description":"ICD-CGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bleeding control","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91651","description":"Anesth bleeding control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA1","description":"ICD-CFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB0","description":"ICD-HBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99425","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81432","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0901","description":"CDT-D0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction rectal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45190","description":"Destruction rectal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77316","description":"Brachytx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neutron beam tx simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77422","description":"Neutron beam tx simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF1","description":"ICD-PJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF1","description":"ICD-GGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50557","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Musc tst done w/n tst nonext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95887","description":"Musc tst done w/n tst nonext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF1","description":"ICD-GFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen skin test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3031","description":"Collagen skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB0","description":"ICD-KIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND0","description":"ICD-KCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF1","description":"ICD-EAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB0","description":"ICD-OHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise epiphyseal bar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20150","description":"Excise epiphyseal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skin ext/per/atrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40051","description":"Anesth skin ext/per/atrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD0","description":"ICD-KEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB1","description":"ICD-MHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA0","description":"ICD-GGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB0","description":"ICD-FGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat lordotc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71021","description":"Chest x-ray frnt lat lordotc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD1","description":"ICD-CEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB0","description":"ICD-CHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB0","description":"ICD-DIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA151","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB0","description":"ICD-BHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF1","description":"ICD-CHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0908T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","description":"CPT-0908T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA1","description":"ICD-MGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ lyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9319","description":"Injection_ romidepsin_ lyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc rspse chmotx rx motility cntrst tomography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083U","description":"Onc rspse chmotx rx motility cntrst tomography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj same drug adon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96376","description":"Tx/pro/dx inj same drug adon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9493","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF1","description":"ICD-CDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF0","description":"ICD-IDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287U","description":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC1","description":"ICD-KDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25310","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD1","description":"ICD-MBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfo without joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3924","description":"Hfo without joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD1","description":"ICD-MIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA0","description":"ICD-JEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9538","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF1","description":"ICD-OFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF0","description":"ICD-CCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction susp ak/knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5652","description":"Suction susp ak/knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF1","description":"ICD-MCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50785","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE0","description":"ICD-GAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection abdominal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49427","description":"Injection abdominal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61585","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF0","description":"ICD-LEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telescop/othr compound lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2615","description":"Telescop/othr compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB1","description":"ICD-HAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE1","description":"ICD-EICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB0","description":"ICD-CHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81554","description":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55200","description":"Incision of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA0","description":"ICD-KBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot non-stndard size/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3254","description":"Orth foot non-stndard size/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20824","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3573F","description":"Pt not consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB1","description":"ICD-ICLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47300","description":"Surgery for liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL30","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0543T","description":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC201","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC214","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF0","description":"ICD-MLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8C","description":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0775T","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF0","description":"ICD-HAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0404","description":"HCPCS-B0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md service required for pmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0372","description":"Md service required for pmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE0","description":"ICD-MLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE1","description":"ICD-GHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA26","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anidulafungin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0348","description":"Anidulafungin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB0","description":"ICD-GHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE0","description":"ICD-FFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF0","description":"ICD-OIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collect sweat for test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89230","description":"Collect sweat for test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6567","description":"Gradient compression garment_ neck/head_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum/swg pha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5830","description":"Endo knee-shin pneum/swg pha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA0","description":"ICD-GAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8F","description":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF0","description":"ICD-EGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF0","description":"ICD-CIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA0","description":"ICD-MEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF0","description":"ICD-OIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL11","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney dialysate delivry sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1510","description":"Kidney dialysate delivry sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB1","description":"ICD-CIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8A","description":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA0","description":"ICD-MIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22110","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conformal radn thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4181F","description":"Conformal radn thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 15 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175U","description":"PSYC GEN ALYS PANEL 15 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB0","description":"ICD-JDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB0","description":"ICD-GDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF1","description":"ICD-BGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC0","description":"ICD-NHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF1","description":"ICD-NANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF1","description":"ICD-MCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD0","description":"ICD-KDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC0","description":"ICD-DGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics dna probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88271","description":"Cytogenetics dna probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bls-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0429","description":"Bls-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF1","description":"ICD-ICDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA1","description":"ICD-FDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD0","description":"ICD-BDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC0","description":"ICD-OFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25560","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2031","description":"Mh clubhouse svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC0","description":"ICD-NLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0488U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","description":"CPT-0488U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0456","description":"Tlso flex trnk sj-ss pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF1","description":"ICD-FBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81190","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gammagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4111","description":"Gammagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE0","description":"ICD-GAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF1","description":"ICD-OAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA0","description":"ICD-CFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC1","description":"ICD-LDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC0","description":"ICD-OGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood ph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82800","description":"Blood ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj celiac pelus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64530","description":"N block inj celiac pelus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF1","description":"ICD-MLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8013","description":"HCPCS-C8013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB0","description":"ICD-KCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam unilat ribs/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71101","description":"X-ray exam unilat ribs/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF1","description":"ICD-EGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93010","description":"Electrocardiogram report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA1","description":"ICD-PGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC1","description":"ICD-GFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1278","description":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB1","description":"ICD-ODUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA0","description":"ICD-GBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB1","description":"ICD-EFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD0","description":"ICD-OCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct inverted nipple(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19355","description":"Correct inverted nipple(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imported lipodox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2049","description":"Imported lipodox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoprostenol dilutant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0155","description":"Epoprostenol dilutant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5B","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA0","description":"ICD-GIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38531","description":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inlay composite/resin one su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2650","description":"Inlay composite/resin one su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC0","description":"ICD-IBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88321","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE1","description":"ICD-KCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD0","description":"ICD-DCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE0","description":"ICD-KCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD1","description":"ICD-AFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pessary rubber_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4561","description":"Pessary rubber_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA0","description":"ICD-JFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE1","description":"ICD-AHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8F","description":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA1","description":"ICD-CEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD0","description":"ICD-JELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD156","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft pros&vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35681","description":"Composite byp grft pros&vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retainer Crown 3/4 - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6784","description":"Retainer Crown 3/4 - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin sign vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2002F","description":"Clin sign vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD1","description":"ICD-ADTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA11","description":"ICD-2CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF0","description":"ICD-NABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15854","description":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA0","description":"ICD-ABHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF1","description":"ICD-OLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1192","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC0","description":"ICD-IAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC1","description":"ICD-CGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB0","description":"ICD-GCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD1","description":"ICD-GIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD1","description":"ICD-NFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52330","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sys bp > or = 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8753","description":"Sys bp > or = 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other counselor at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9475","description":"Other counselor at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE0","description":"ICD-BBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD0","description":"ICD-PJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2247","description":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC0","description":"ICD-FEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE1","description":"ICD-JGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF0","description":"ICD-NADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE0","description":"ICD-NILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC1","description":"ICD-OCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC0","description":"ICD-GCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC0","description":"ICD-FAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA0","description":"ICD-BEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF1","description":"ICD-IGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82653","description":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD0","description":"ICD-OLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE0","description":"ICD-GHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Papaverin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2440","description":"Papaverin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0601","description":"HCPCS-C0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3A","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF1","description":"ICD-OHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE1","description":"ICD-NFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB31","description":"ICD-3BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Next Generation ACO model_ 10-20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9869","description":"Next Generation ACO model_ 10-20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB0","description":"ICD-NIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metyrapone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80436","description":"Metyrapone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD1","description":"ICD-NHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE0","description":"ICD-PKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80304","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE1","description":"ICD-BFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF0","description":"ICD-GAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB0","description":"ICD-HBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB0","description":"ICD-AHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB1","description":"ICD-ADIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral surgery procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7999","description":"Oral surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED1","description":"ICD-FCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF1","description":"ICD-OGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92553","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icm device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93290","description":"Icm device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual acuity screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99173","description":"Visual acuity screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2127","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54830","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0886","description":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB0","description":"ICD-CAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2B","description":"Very High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB1","description":"ICD-CDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD0","description":"ICD-GGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND0","description":"ICD-OFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD0","description":"ICD-MFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59320","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27409","description":"Repair of knee ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62292","description":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB52","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9257","description":"Doc stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42200","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA1","description":"ICD-CBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB0","description":"ICD-EICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preparation palate mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42280","description":"Preparation palate mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD0","description":"ICD-FCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56606","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF0","description":"ICD-AIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transition service coordination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7337","description":"Transition service coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB1","description":"ICD-BDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC1","description":"ICD-JFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC1","description":"ICD-IDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA0","description":"ICD-CEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE1","description":"ICD-PEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF1","description":"ICD-MDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain neck/chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21501","description":"Drain neck/chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"H pylori (c-13) blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83009","description":"H pylori (c-13) blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB1","description":"ICD-OBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57320","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE1","description":"ICD-IEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA0","description":"ICD-BFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA1","description":"ICD-MJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0885","description":"Epoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0701T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Jaw motion rehab system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1700","description":"Jaw motion rehab system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Each addtnl cast post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2953","description":"Each addtnl cast post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1105T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1105T","description":"CPT-1105T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC0","description":"ICD-MFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11772","description":"Remove pilonidal cyst compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA1","description":"ICD-OEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0591T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA1","description":"ICD-PLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self care d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8989","description":"Self care d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE0","description":"ICD-DFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA0","description":"ICD-OJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial limited study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93888","description":"Intracranial limited study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB0","description":"ICD-FIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE1","description":"ICD-BFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD0","description":"ICD-ACUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct guide for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77013","description":"Ct guide for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE0","description":"ICD-OCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED1","description":"ICD-BEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF1","description":"ICD-OKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50810","description":"Fusion of ureter & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27786","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3C","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE0","description":"ICD-BCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98970","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL40","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red cell survival study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78130","description":"Red cell survival study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amantadine hcl oral brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9033","description":"Amantadine hcl oral brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug/bio noc part b drug cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4082","description":"Drug/bio noc part b drug cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF1","description":"ICD-CDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD0","description":"ICD-FHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB1","description":"ICD-JCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5B","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scap thorac prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6570","description":"Scap thorac prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9982","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vestibular test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92533","description":"Caloric vestibular test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC1","description":"ICD-OAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA0","description":"ICD-MFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78306","description":"Bone imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision secondary cataract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66820","description":"Incision secondary cataract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB0","description":"ICD-EBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE1","description":"ICD-KFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC NONSM CLL LNG CA ALYS 23","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179U","description":"ONC NONSM CLL LNG CA ALYS 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD1","description":"ICD-LDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF0","description":"ICD-IHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0177","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF1","description":"ICD-OGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01742","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","description":"CPT-01742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB0","description":"ICD-JCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB0","description":"ICD-GIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE0","description":"ICD-BFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB0","description":"ICD-FHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB0","description":"ICD-OLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no ref oto reas no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8563","description":"Pt no ref oto reas no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC1","description":"ICD-IBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB0","description":"ICD-CAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aoe intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9465","description":"Aoe intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA1","description":"ICD-GDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF1","description":"ICD-CBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA1","description":"ICD-CAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED0","description":"ICD-OIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2144","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27758","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE0","description":"ICD-NHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE0","description":"ICD-JATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF1","description":"ICD-KFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB0","description":"ICD-KDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma valve w diaphra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7501","description":"Tracheostoma valve w diaphra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB0","description":"ICD-LEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF0","description":"ICD-GAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC0","description":"ICD-GBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3d photographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0351","description":"3d photographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA0","description":"ICD-BCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck follup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9554","description":"CT/MRI chest/neck follup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periacetabular osteotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2115","description":"Periacetabular osteotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90684","description":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lower limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5781","description":"Lower limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable nebulizer prefill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7008","description":"Disposable nebulizer prefill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE0","description":"ICD-OLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg =3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6441","description":"Pad band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE1","description":"ICD-NGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA0","description":"ICD-EEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF1","description":"ICD-GIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC0","description":"ICD-MEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt=d(rh)- and unsensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3290F","description":"Pt=d(rh)- and unsensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF0","description":"ICD-PDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 23+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP23","description":"Auto test panel pricing code_ 23+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC1","description":"ICD-GAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","description":"CPT-00940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF0","description":"ICD-AEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF1","description":"ICD-IFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF1","description":"ICD-IBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB0","description":"ICD-CHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6010F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB1","description":"ICD-AGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF1","description":"ICD-NGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML16","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA0","description":"ICD-KGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 13/> studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95913","description":"Nrv cndj test 13/> studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA13","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0595U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","description":"CPT-0595U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD120","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult day center_ 8-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0530","description":"Adult day center_ 8-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB0","description":"ICD-OLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB1","description":"ICD-MBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures maxill part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5211","description":"Dentures maxill part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bp not performed/doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8478","description":"Bp not performed/doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA1","description":"ICD-OETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8X","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE0","description":"ICD-OEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE0","description":"ICD-NGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for >6 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1135F","description":"Epsd bk pain for >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD0","description":"ICD-MJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17283","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA1","description":"ICD-NHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj protirelin per 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2725","description":"Inj protirelin per 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DNA analysis_ fecal_ for colorectal cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3890","description":"DNA analysis_ fecal_ for colorectal cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21280","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8G","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB0","description":"ICD-IECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA1","description":"ICD-NCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84392","description":"Assay of urine sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE0","description":"ICD-CBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90687","description":"Iiv4 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF0","description":"ICD-GEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC1","description":"ICD-LFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB1","description":"ICD-KGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB0","description":"ICD-EGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0875T","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE0","description":"ICD-OGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4388","description":"Drainable pch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD1","description":"ICD-NLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation caregiver is trained and certified in dementia care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2185","description":"Documentation caregiver is trained and certified in dementia care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC1","description":"ICD-PLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC0","description":"ICD-BIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE124","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC1","description":"ICD-KHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD0","description":"ICD-ODFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2C","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD0","description":"ICD-GERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Misc vision item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2799","description":"Misc vision item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15823","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC0","description":"ICD-KGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nervous system nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78699","description":"Nervous system nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergy/immunology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0060","description":"Allergy/immunology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Image std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9318","description":"Image std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD1","description":"ICD-CEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0618","description":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olanzapine_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2359","description":"Injection_ olanzapine_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB1","description":"ICD-GDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine lumbar/sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62311","description":"Inject spine lumbar/sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB0","description":"ICD-KFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE1","description":"ICD-OALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0027","description":"Semen analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transab or transvag us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8806","description":"Transab or transvag us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA1","description":"ICD-FDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB1","description":"ICD-KACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA1","description":"ICD-BDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51610","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC1","description":"ICD-FDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53235","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA21","description":"ICD-1KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB32","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB0","description":"ICD-IIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC110","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE1","description":"ICD-NCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE0","description":"ICD-FGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11750","description":"Removal of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC1","description":"ICD-NFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA0","description":"ICD-MGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77437","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","description":"CPT-77437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclr rx interstit colloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79300","description":"Nuclr rx interstit colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF1","description":"ICD-DBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL30","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0504T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25312","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD0","description":"ICD-CCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA1","description":"ICD-PJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0152U","description":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF0","description":"ICD-CADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83655","description":"Assay of lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF1","description":"ICD-PASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC0","description":"ICD-MFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE1","description":"ICD-HAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1811","description":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD0","description":"ICD-OIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF0","description":"ICD-AHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraction coronal remnants","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7111","description":"Extraction coronal remnants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93585","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1160","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE0","description":"ICD-MHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB0","description":"ICD-OGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","description":"CPT-15015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF1","description":"ICD-KHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5214","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064U","description":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27808","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC0","description":"ICD-KDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2B","description":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF1","description":"ICD-FCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF1","description":"ICD-LCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem_ vaborbactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2186","description":"Injection_ meropenem_ vaborbactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73221","description":"MRI joint upr extrem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9410","description":"Admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD1","description":"ICD-JCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB231","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69602","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF1","description":"ICD-FGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC0","description":"ICD-PISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC1","description":"ICD-CIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy abdominal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49180","description":"Biopsy abdominal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC1","description":"ICD-OLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB50","description":"Low Rehab_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD1","description":"ICD-GCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD0","description":"ICD-DASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52450","description":"Incision of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1006","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC1","description":"ICD-PCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE1","description":"ICD-BBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81108","description":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cellular therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0075","description":"Cellular therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47534","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42425","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA0","description":"ICD-CGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/strip long leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37722","description":"Ligate/strip long leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16078","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16078","description":"CPT-16078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit declotting kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5517","description":"Hit declotting kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89280","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj ferric pyrophosphate cit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1443","description":"Inj ferric pyrophosphate cit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND0","description":"ICD-NCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA1","description":"ICD-MHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0817T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC0","description":"ICD-NGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD1","description":"ICD-BAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF0","description":"ICD-NGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB0","description":"ICD-JIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE1","description":"ICD-MFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE1","description":"ICD-OJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD1","description":"ICD-EFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE1","description":"ICD-KGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1741","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1741","description":"HCPCS-C1741","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB0","description":"ICD-MBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69005","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3204","description":"Hightop w/ supp/pronator inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC0","description":"ICD-OKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB0","description":"ICD-HCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1114","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49440","description":"Place gastrostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB1","description":"ICD-CEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB0","description":"ICD-CBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA0","description":"ICD-GCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA1","description":"ICD-BEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93799","description":"Cardiovascular procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA1","description":"ICD-JFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sisi hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92564","description":"Sisi hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB0","description":"ICD-GCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD1","description":"ICD-HHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1502","description":"HCPCS-A1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71047","description":"Radiologic examination_ chest; 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB1","description":"ICD-GFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC12","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inhaled bronchodilator rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4025F","description":"Inhaled bronchodilator rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE0","description":"ICD-GAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE0","description":"ICD-OLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE0","description":"ICD-OCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB17","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD0","description":"ICD-LASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC1","description":"ICD-GCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx cesium-131 chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2644","description":"Brachytx cesium-131 chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB0","description":"ICD-BILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA0","description":"ICD-BDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF0","description":"ICD-DEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frame depth less than 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2203","description":"Frame depth less than 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID0","description":"ICD-JHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77332","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD0","description":"ICD-AHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB1","description":"ICD-BEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43611","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF1","description":"ICD-DDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0849T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA1","description":"ICD-OABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE0","description":"ICD-FBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED0","description":"ICD-NGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82247","description":"Bilirubin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB0","description":"ICD-KGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flex foot system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5980","description":"Flex foot system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB1","description":"ICD-EABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD1","description":"ICD-BGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCD0","description":"ICD-MHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA40","description":"Ultra High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ZZZZZ","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ZZZZZ","description":"ICD-ZZZZZ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF0","description":"ICD-KGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD1","description":"ICD-NCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC1","description":"ICD-NCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67975","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy premal lesions 15/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17004","description":"Destroy premal lesions 15/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surfactant admin thru tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94610","description":"Surfactant admin thru tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91321","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40651","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA1","description":"ICD-KITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pure tone hearing test air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92551","description":"Pure tone hearing test air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB206","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vit for macular pucker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67041","description":"Vit for macular pucker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9997","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","description":"HCPCS-Q9997","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE1","description":"ICD-OGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC1","description":"ICD-AFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Financial management_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2050","description":"Financial management_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75957","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imatinib 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0088","description":"Imatinib 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF1","description":"ICD-GDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33025","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA1","description":"ICD-NBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF1","description":"ICD-PERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rectal catheter for use with the manual pump-operated enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4453","description":"Rectal catheter for use with the manual pump-operated enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96910","description":"Photochemotherapy with uv-b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC0","description":"ICD-PKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB0","description":"ICD-IDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB1","description":"ICD-CBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA1","description":"ICD-KGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC1","description":"ICD-FDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA1","description":"ICD-OGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB0","description":"ICD-FBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87482","description":"Candida dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25491","description":"Reinforce ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonemerg transp mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0215","description":"Nonemerg transp mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE1","description":"ICD-FDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of palm bursas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26030","description":"Drainage of palm bursas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC0","description":"ICD-JCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9083","description":"Onc dx prostate unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD1","description":"ICD-FEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43286","description":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27045","description":"Exc hip/pelv tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73510","description":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1177","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc of dsm-iv init eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9212","description":"Doc of dsm-iv init eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC0","description":"ICD-CFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263T","description":"Im b1 mrw cel ther cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Otolaryngology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4022","description":"Otolaryngology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27134","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1222","description":"Glaucoma plan of care not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vitreoretinal surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14551","description":"Anesth vitreoretinal surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD0","description":"ICD-GGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD0","description":"ICD-MADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD0","description":"ICD-BIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pi volunteer ambulance co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0432","description":"Pi volunteer ambulance co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl stg 3-4 not relap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9135","description":"Onc dx nhl stg 3-4 not relap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB16","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33405","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA1","description":"ICD-BDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA1","description":"ICD-IBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace cover w/c seat cush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2619","description":"Replace cover w/c seat cush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA1","description":"ICD-NBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE0","description":"ICD-JDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA0","description":"ICD-KIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0800T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB0","description":"ICD-JAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC0","description":"ICD-AELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0850T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5277","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF0","description":"ICD-AEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenothiazine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6057","description":"Phenothiazine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB1","description":"ICD-GGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0984T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","description":"CPT-0984T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1202","description":"CDT-D1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0804","description":"HCPCS-B0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC1","description":"ICD-AITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp common ipsi carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35601","description":"Art byp common ipsi carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB0","description":"ICD-PIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC0","description":"ICD-EELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB0","description":"ICD-KDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB0","description":"ICD-JIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB0","description":"ICD-CCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1705","description":"HCPCS-A1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol > 100gm prote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4199","description":"Parenteral sol > 100gm prote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","description":"HCPCS-M1408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tablo Hemodialysis System For The Billable Dialysis Service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1629","description":"Tablo Hemodialysis System For The Billable Dialysis Service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ single mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2366","description":"Battery charger_ single mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC0","description":"ICD-IFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD1","description":"ICD-LHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86817","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychoed svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2027","description":"Psychoed svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE0","description":"ICD-OADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF1","description":"ICD-OFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99316","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95713","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD0","description":"ICD-GGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retrieval of oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58970","description":"Retrieval of oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9056","description":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB1","description":"ICD-BGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary stress test/simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94620","description":"Pulmonary stress test/simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC225","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC1","description":"ICD-OESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit diuretic infus diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9361","description":"Hit diuretic infus diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB0","description":"ICD-PDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB1","description":"ICD-MLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA0","description":"ICD-KDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00192","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","description":"CPT-00192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9064","description":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB1","description":"ICD-KETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF1","description":"ICD-HDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF1","description":"ICD-GIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/bladder repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51925","description":"Hysterectomy/bladder repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of uterus lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58100","description":"Biopsy of uterus lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA1","description":"ICD-AIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC1","description":"ICD-OHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF1","description":"ICD-OHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD0","description":"ICD-AIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD1","description":"ICD-GBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB0","description":"ICD-FEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehab w exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0424","description":"Pulmonary rehab w exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0372","description":"intraoral tomosynthesis - comprehensive series of radiographic images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33288","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF1","description":"ICD-ACUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA0","description":"ICD-HDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC1","description":"ICD-BBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA0","description":"ICD-JGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD0","description":"ICD-HDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE1","description":"ICD-ODBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD1","description":"ICD-JCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD1","description":"ICD-OHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0805","description":"CDT-D0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE0","description":"ICD-BGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD0","description":"ICD-CHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF1","description":"ICD-BDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA0","description":"ICD-LARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC1","description":"ICD-MKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quality care in mental health and substance use disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1369","description":"Quality care in mental health and substance use disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6060","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB1","description":"ICD-JEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA0","description":"ICD-FHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX45","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0577","description":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC0","description":"ICD-GHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy surg colpopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57425","description":"Laparoscopy surg colpopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA1","description":"ICD-ODPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0A","description":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43865","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB0","description":"ICD-FIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50684","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Durable medical equipment mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1399","description":"Durable medical equipment mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95990","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27395","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe suscept mycobacteri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87190","description":"Microbe suscept mycobacteri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF0","description":"ICD-MHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex h rate sz 30+ day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386T","description":"Ex h rate sz 30+ day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38382","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80339","description":"Antiepileptics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67025","description":"Replace eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB0","description":"ICD-IHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC1","description":"ICD-IIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93531","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD0","description":"ICD-NFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0103","description":"CDT-D0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue allograft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4275","description":"Soft tissue allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA0","description":"ICD-IHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63709","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21087","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE0","description":"ICD-JBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB0","description":"ICD-DHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC0","description":"ICD-AADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria x10sv endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33266","description":"Ablate atria x10sv endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2525","description":"Th/wght bear nar m-l brim mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF1","description":"ICD-IATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC0","description":"ICD-ECDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB0","description":"ICD-KDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1052T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1052T","description":"CPT-1052T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin k","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84597","description":"Assay of vitamin k","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64865","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert vad artery access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33990","description":"Insert vad artery access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE1","description":"ICD-JBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES241","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21627","description":"Sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33997","description":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opps/php; train & educ serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0177","description":"Opps/php; train & educ serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic image bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77084","description":"Magnetic image bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA1","description":"ICD-GCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA1","description":"ICD-IBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1245","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95836","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nelarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9261","description":"Nelarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA1","description":"ICD-NLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69511","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF1","description":"ICD-JGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF0","description":"ICD-LDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA1","description":"ICD-GBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE0","description":"ICD-KIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC1","description":"ICD-FIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna/rna hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87902","description":"Genotype dna/rna hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0872","description":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF1","description":"ICD-CERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC1","description":"ICD-GGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaginectomy partial w/nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57109","description":"Vaginectomy partial w/nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF0","description":"ICD-DBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0435","description":"Fixed wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC1","description":"ICD-CDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE1","description":"ICD-GAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49501","description":"Rpr ing hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE0","description":"ICD-MATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID1","description":"ICD-KAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89251","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spacer bag/reservoir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4627","description":"Spacer bag/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20101","description":"Explore wound chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB0","description":"ICD-FBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA1","description":"ICD-FECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF1","description":"ICD-NIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hymenotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56442","description":"Hymenotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA31","description":"ICD-2EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF1","description":"ICD-KHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9298","description":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55605","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC31","description":"ICD-2KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC0","description":"ICD-CDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD1","description":"ICD-OADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD1","description":"ICD-BAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF0","description":"ICD-GBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8X","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB1","description":"ICD-JAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91110","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC1","description":"ICD-ACEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA0","description":"ICD-JFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC0","description":"ICD-KEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35005","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC0","description":"ICD-NINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1503","description":"HCPCS-A1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85014","description":"Hematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0561T","description":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF1","description":"ICD-OEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57410","description":"Pelvic examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA0","description":"ICD-GECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD0","description":"ICD-NKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF0","description":"ICD-LHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC1","description":"ICD-KGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasma_ frz between 8-24hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9059","description":"Plasma_ frz between 8-24hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rabies ig heat treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90376","description":"Rabies ig heat treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB31","description":"ICD-2HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED1","description":"ICD-IBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2122","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1455","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","description":"HCPCS-M1455","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE0","description":"ICD-JHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC1","description":"ICD-NFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC1","description":"ICD-DBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD1","description":"ICD-PGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans elec jt stim dev sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0762","description":"Trans elec jt stim dev sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1026","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA0","description":"ICD-ODGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD0","description":"ICD-AFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63020","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE1","description":"ICD-JCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE0","description":"ICD-NHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD1","description":"ICD-MFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC1","description":"ICD-NCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB0","description":"ICD-GISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF1","description":"ICD-NGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteogen ultrasound stimltor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0760","description":"Osteogen ultrasound stimltor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94451","description":"Anesth vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC0","description":"ICD-BIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41827","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA14","description":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE1","description":"ICD-LIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscope w/vc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31570","description":"Laryngoscope w/vc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC1","description":"ICD-JEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4526","description":"Adult size pull-on med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA0","description":"ICD-HISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF1","description":"ICD-ODLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16371","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16371","description":"CPT-16371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB1","description":"ICD-ADBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD1","description":"ICD-PFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36474","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC0","description":"ICD-BAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair fixed retainers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8694","description":"Repair fixed retainers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay chondroitin sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82485","description":"Assay chondroitin sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB1","description":"ICD-OLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1241","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD1","description":"ICD-NKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC0","description":"ICD-IGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69643","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB1","description":"ICD-OJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB1","description":"ICD-CEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0751T","description":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB1","description":"ICD-ODAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD1","description":"ICD-PEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX35","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE0","description":"ICD-GGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA0","description":"ICD-OGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","description":"CPT-00145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC1","description":"ICD-FFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of carnitine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82379","description":"Assay of carnitine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD0","description":"ICD-NILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ureter calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51065","description":"Remove ureter calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC0","description":"ICD-IHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA0","description":"ICD-FDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed re ft care inspct rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4305F","description":"Pt ed re ft care inspct rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD0","description":"ICD-KBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9272","description":"Injection_ dostarlimab-gxly_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC1","description":"ICD-FHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attendance at delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99464","description":"Attendance at delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69502","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9404","description":"No 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx cast plaster mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2106","description":"Afo tib fx cast plaster mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD1","description":"ICD-CCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA0","description":"ICD-KDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC1","description":"ICD-KHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infus pump portab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9004","description":"Parenteral infus pump portab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC0","description":"ICD-HBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA0","description":"ICD-OLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuragen nerve guide_ per cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9352","description":"Neuragen nerve guide_ per cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Op rad mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9236","description":"Op rad mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA0","description":"ICD-CBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3371","description":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopic sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92614","description":"Laryngoscopic sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm a-grft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15115","description":"Epidrm a-grft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD0","description":"ICD-EDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF1","description":"ICD-GGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC0","description":"ICD-HEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC1","description":"ICD-BBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90703","description":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42106","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal seg width over","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2219","description":"Lens bifocal seg width over","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE1","description":"ICD-KIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC1","description":"ICD-IBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular flow imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78445","description":"Vascular flow imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED1","description":"ICD-JEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB1","description":"ICD-KEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58660","description":"Laparoscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470U","description":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52224","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX53","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert uro/ves nck sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53445","description":"Insert uro/ves nck sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC0","description":"ICD-OLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB1","description":"ICD-PEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC1","description":"ICD-EIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 51 GENE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217U","description":"NEURO INH ATAXIA DNA 51 GENE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE0","description":"ICD-NLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1102T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1102T","description":"CPT-1102T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC1","description":"ICD-FEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admin hepatitis b vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0010","description":"Admin hepatitis b vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB53","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD1","description":"ICD-DEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA0","description":"ICD-KEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE0","description":"ICD-DGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA0","description":"ICD-GHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE1","description":"ICD-NDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42831","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC0","description":"ICD-ICCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0173","description":"Trimethobenzamide hcl 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9900","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0536T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE0","description":"ICD-BDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB0","description":"ICD-IDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC0","description":"ICD-IEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA0","description":"ICD-JCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32400","description":"Needle biopsy chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnanetriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84138","description":"Assay of pregnanetriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uvl replacement bulb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4633","description":"Uvl replacement bulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral supp not otherwise c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9998","description":"Enteral supp not otherwise c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF1","description":"ICD-JBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE1","description":"ICD-LDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB1","description":"ICD-OERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD0","description":"ICD-FDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC0","description":"ICD-NCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In111 ibritumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9542","description":"In111 ibritumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair fem hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49555","description":"Rerepair fem hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0820","description":"Pwc gp 2 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC0","description":"ICD-NLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56159","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF0","description":"ICD-GCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iv hanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0105","description":"Iv hanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21554","description":"Exc neck tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA0","description":"ICD-OALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51570","description":"Removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport meals escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0210","description":"Noner transport meals escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture typing added method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87158","description":"Culture typing added method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mast subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19304","description":"Mast subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB52","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain open lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32200","description":"Drain open lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD1","description":"ICD-EFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE1","description":"ICD-OHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE0","description":"ICD-FEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82677","description":"Assay of estriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC1","description":"ICD-OEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC0","description":"ICD-PBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote dx retinal imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92227","description":"Remote dx retinal imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA46","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 15-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86300","description":"Immunoassay tumor ca 15-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA0","description":"ICD-MABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0D","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hm gest dm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9214","description":"Hm gest dm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE1","description":"ICD-JFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trac stand free stand pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0900","description":"Trac stand free stand pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD0","description":"ICD-AFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB1","description":"ICD-OEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC113","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy_ in the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9129","description":"Occupational therapy_ in the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA17","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3A","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD0","description":"ICD-OEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB0","description":"ICD-MLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78103","description":"Bone marrow imaging mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE251","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74425","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70553","description":"MRI brain stem w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA0","description":"ICD-NKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB1","description":"ICD-MHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB225","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA0","description":"ICD-BFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92972","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE0","description":"ICD-NELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF1","description":"ICD-JHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smoking cessation gum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4995","description":"Smoking cessation gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB1","description":"ICD-NDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC0","description":"ICD-FHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF1","description":"ICD-CABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE0","description":"ICD-EHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC0","description":"ICD-MJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12035","description":"Intmd rpr s/a/t/ext 12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC1","description":"ICD-BAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo calf/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4090","description":"Repl met band kafo-afo calf/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy addl lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63044","description":"Laminotomy addl lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD0","description":"ICD-CAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES221","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA0","description":"ICD-FEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68745","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93461","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC0","description":"ICD-CEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA1","description":"ICD-AFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB0","description":"ICD-DDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE1","description":"ICD-LHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF1","description":"ICD-LBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA0","description":"ICD-JDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release/revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50725","description":"Release/revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC0","description":"ICD-OKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert needle cath bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44015","description":"Insert needle cath bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8F","description":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tacrolimus imme rel oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7507","description":"Tacrolimus imme rel oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF1","description":"ICD-CDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF0","description":"ICD-JCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC0","description":"ICD-CFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB1","description":"ICD-GAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF1","description":"ICD-ODGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc visceral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235T","description":"Trluml perip athrc visceral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD1","description":"ICD-OJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0088U","description":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE1","description":"ICD-NCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD146","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD1","description":"ICD-GDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC0","description":"ICD-DHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB1","description":"ICD-CGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB0","description":"ICD-EEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC0","description":"ICD-NIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB1","description":"ICD-CEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML30","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33230","description":"Insrt pulse gen w/dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB0","description":"ICD-IEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2089","description":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8F","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD1","description":"ICD-FDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF1","description":"ICD-OBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine nrv half segmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63185","description":"Incise spine nrv half segmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE1","description":"ICD-HDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB0","description":"ICD-OCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE1","description":"ICD-GIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82672","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26820","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE201","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla or mandible resectio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7490","description":"Maxilla or mandible resectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD0","description":"ICD-NHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC145","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND0","description":"ICD-NDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA1","description":"ICD-CIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF0","description":"ICD-OKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF1","description":"ICD-JIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0B","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9302","description":"HCPCS-C9302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telescopic intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1840","description":"Telescopic intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB1","description":"ICD-EILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF1","description":"ICD-MGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC1","description":"ICD-GFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Salivary gland function exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78232","description":"Salivary gland function exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD0","description":"ICD-DDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic venous therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37212","description":"Thrombolytic venous therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA1","description":"ICD-MGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70548","description":"Mr angiography neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB0","description":"ICD-JHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA0","description":"ICD-CAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD260","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bend only l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72120","description":"X-ray bend only l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9776","description":"Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g._ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE0","description":"ICD-NBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC0","description":"ICD-JDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA0","description":"ICD-HHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44188","description":"Lap colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lanreotide_ (Cipla)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1932","description":"Injection_ lanreotide_ (Cipla)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE0","description":"ICD-JDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD1","description":"ICD-CEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE0","description":"ICD-KATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE1","description":"ICD-NIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA0","description":"ICD-HIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic treatment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8690","description":"Orthodontic treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF0","description":"ICD-CESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA1","description":"ICD-PKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance (eg_ vibration) elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76391","description":"Magnetic resonance (eg_ vibration) elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69650","description":"Release middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE1","description":"ICD-ICLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So hard plas stabili pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3677","description":"So hard plas stabili pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnioexcel or biodexcel_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4137","description":"Amnioexcel or biodexcel_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA1","description":"ICD-FIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96372","description":"Ther/proph/diag inj sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amphetamines 3or 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80325","description":"Amphetamines 3or 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21244","description":"Reconstruction of lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA1","description":"ICD-FIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB1","description":"ICD-CIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE0","description":"ICD-NLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA1","description":"ICD-KIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB1","description":"ICD-JCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Activity therapy_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2032","description":"Activity therapy_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID0","description":"ICD-JIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9431","description":"No pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB0","description":"ICD-GGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC1","description":"ICD-IGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD0","description":"ICD-BIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine flow measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51736","description":"Urine flow measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Latex suspension sleeve each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6632","description":"Latex suspension sleeve each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA1","description":"ICD-EBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC1","description":"ICD-KCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA1","description":"ICD-FEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE0","description":"ICD-OGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES145","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA1","description":"ICD-OHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE0","description":"ICD-JEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech therapy_ in the home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9128","description":"Speech therapy_ in the home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1357","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC1","description":"ICD-CIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE0","description":"ICD-GGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB1","description":"ICD-OFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD1","description":"ICD-OLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA1","description":"ICD-GHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF0","description":"ICD-LARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1902","description":"CDT-D1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA1","description":"ICD-GARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC0","description":"ICD-AHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lo rig pos pnl l1-l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0641","description":"Lo rig pos pnl l1-l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Sandwich","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1761","description":"Home Delivered Meals-Sandwich","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD0","description":"ICD-JCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB1","description":"ICD-IGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC0","description":"ICD-ECLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF0","description":"ICD-PGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF0","description":"ICD-KCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD0","description":"ICD-FEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC0","description":"ICD-EGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF1","description":"ICD-OGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj diagnostic arthroscopy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7872","description":"Tmj diagnostic arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD0","description":"ICD-MBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of skull arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61711","description":"Fusion of skull arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA0","description":"ICD-OFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF0","description":"ICD-BHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung extrapleural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32445","description":"Removal of lung extrapleural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27337","description":"Exc thigh/knee les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42426","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","description":"HCPCS-Q4419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144U","description":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC1","description":"ICD-EFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD144","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF1","description":"ICD-MHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC0","description":"ICD-AFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ekg interpret & report preve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0405","description":"Ekg interpret & report preve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF1","description":"ICD-KDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB0","description":"ICD-FFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB1","description":"ICD-OFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB0","description":"ICD-GAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC254","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE0","description":"ICD-OEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no pt cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9429","description":"Doc med reas no pt cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD1","description":"ICD-AITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA1","description":"ICD-NKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD0","description":"ICD-JHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC1","description":"ICD-OBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF1","description":"ICD-CCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB0","description":"ICD-NDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX42","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ bra_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6589","description":"Gradient pressure wrap with adjustable straps_ bra_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC1","description":"ICD-AHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE0","description":"ICD-DBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA1","description":"ICD-OGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF0","description":"ICD-OADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9506","description":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD1","description":"ICD-BCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interdental wiring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21497","description":"Interdental wiring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD0","description":"ICD-FEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo single coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1777","description":"Lead_ aicd_ endo single coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC1","description":"ICD-GGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE1","description":"ICD-OCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA54","description":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toxoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86777","description":"Toxoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9309","description":"No unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD0","description":"ICD-LEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB115","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF0","description":"ICD-DHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE1","description":"ICD-OBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC1","description":"ICD-DASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1404","description":"HCPCS-B1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99241","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA0","description":"ICD-BIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF0","description":"ICD-CFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF0","description":"ICD-GFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID1","description":"ICD-GHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA1","description":"ICD-OHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF1","description":"ICD-JBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1826","description":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1015","description":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace lensshield cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4257","description":"Replace lensshield cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA0","description":"ICD-BCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME1","description":"ICD-JGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF0","description":"ICD-LGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF0","description":"ICD-CGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA1","description":"ICD-NLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE0","description":"ICD-AFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE0","description":"ICD-OIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF0","description":"ICD-KAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF1","description":"ICD-KEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX55","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ruconest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0596","description":"Injection_ ruconest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gingival flap proc w/ planin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4240","description":"Gingival flap proc w/ planin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"P32 chromic phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9564","description":"P32 chromic phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE0","description":"ICD-KFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF1","description":"ICD-AGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43287","description":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genetic counseling 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96040","description":"Genetic counseling 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB1","description":"ICD-KHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB1","description":"ICD-GFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF1","description":"ICD-CGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB1","description":"ICD-OFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29040","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB0","description":"ICD-CBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB0","description":"ICD-GFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB1","description":"ICD-AHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA1","description":"ICD-AHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA0","description":"ICD-NGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC0","description":"ICD-FCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olipudase alfa-rpcp_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0218","description":"Injection_ olipudase alfa-rpcp_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enlarge breast with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19325","description":"Enlarge breast with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD1","description":"ICD-BGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF1","description":"ICD-GFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA05","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB1","description":"ICD-OFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC1","description":"ICD-NJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65135","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF1","description":"ICD-EIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA0","description":"ICD-IGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped complete intact nut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4158","description":"Ef ped complete intact nut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syringe w/wo needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4657","description":"Syringe w/wo needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tract frame attach footboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0870","description":"Tract frame attach footboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9798","description":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE0","description":"ICD-MFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF1","description":"ICD-GHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle/rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21705","description":"Revision of neck muscle/rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE0","description":"ICD-BFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC1","description":"ICD-AIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC0","description":"ICD-NBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE0","description":"ICD-IHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB1","description":"ICD-BAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD1","description":"ICD-AGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL33","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24565","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 1-9 dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0304","description":"Pre-op service lvrs 1-9 dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD1","description":"ICD-BDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA0","description":"ICD-OGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD0","description":"ICD-MIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with reactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1232","description":"Patient receives hcv antibody test with reactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD0","description":"ICD-JFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD1","description":"ICD-BHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27050","description":"Biopsy of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF0","description":"ICD-KEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE1","description":"ICD-AIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33986","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45384","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plas doub free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2036","description":"Kafo plas doub free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad sleeve med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8422","description":"Custom grad sleeve med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA1","description":"ICD-GITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62190","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC0","description":"ICD-EILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE0","description":"ICD-DESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD1","description":"ICD-CHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9970","description":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC0","description":"ICD-NEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF1","description":"ICD-NDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC0","description":"ICD-NKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC0","description":"ICD-GIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF1","description":"ICD-OGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes patten bottom t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1755","description":"Legg perthes patten bottom t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF1","description":"ICD-NKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1098","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - soft appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9945","description":"Occlusal guard - soft appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF1","description":"ICD-BCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE0","description":"ICD-DFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD1","description":"ICD-OGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Statin not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9443","description":"Statin not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp guide wire dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43196","description":"Esophagoscp guide wire dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA1","description":"ICD-KDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA1","description":"ICD-EGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain w bar & filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4424","description":"Ost pch drain w bar & filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD1","description":"ICD-BALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA120","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC150","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE0","description":"ICD-FBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA0","description":"ICD-NFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82938","description":"Gastrin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28400","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC1","description":"ICD-OCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial treatment of burn(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16000","description":"Initial treatment of burn(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adalimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0135","description":"Adalimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ppsv23 vacc 2 yrs+ subq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90732","description":"Ppsv23 vacc 2 yrs+ subq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC16","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lamellas_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4292","description":"Lamellas_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb therapy rxd/taken","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4010F","description":"Ace/arb therapy rxd/taken","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE0","description":"ICD-NJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19364","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE0","description":"ICD-LIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF0","description":"ICD-CEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA1","description":"ICD-PHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise thigh tendon & fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27305","description":"Incise thigh tendon & fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1903","description":"HCPCS-A1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE0","description":"ICD-GALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB1","description":"ICD-FBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD1","description":"ICD-OGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01173","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","description":"CPT-01173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF1","description":"ICD-GBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE1","description":"ICD-CCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA1","description":"ICD-ICLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND0","description":"ICD-CEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vehicle mod waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2039","description":"Vehicle mod waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB21","description":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME1","description":"ICD-GCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF0","description":"ICD-NCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5276","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB0","description":"ICD-CIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1131","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF0","description":"ICD-LEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0748T","description":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0536","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","description":"HCPCS-G0536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC0","description":"ICD-NKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE0","description":"ICD-DDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC1","description":"ICD-IDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26428","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC131","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD1","description":"ICD-IATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD1","description":"ICD-CDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas biopsy not review","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8884","description":"Doc reas biopsy not review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC1","description":"ICD-KHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB0","description":"ICD-KFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC0","description":"ICD-PBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC0","description":"ICD-OEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA1","description":"ICD-GBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA1","description":"ICD-OLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vanomycin dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87500","description":"Vanomycin dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC1","description":"ICD-AGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91303","description":"Janssen Covid-19 Vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA1","description":"ICD-NFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6461","description":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA1","description":"ICD-KFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0105","description":"HCPCS-A0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD251","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF1","description":"ICD-EALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC0","description":"ICD-ODUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3051F","description":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pyruvate kinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84220","description":"Assay of pyruvate kinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYA1","description":"ICD-GBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA1","description":"ICD-MLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC0","description":"ICD-HERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glasses binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5150","description":"Glasses binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME0","description":"ICD-GAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF1","description":"ICD-GHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC0","description":"ICD-KDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE154","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF1","description":"ICD-MKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC1","description":"ICD-KGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0812T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA0","description":"ICD-OBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB1","description":"ICD-CGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33776","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB1","description":"ICD-KIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inr measurement performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3555F","description":"Pt inr measurement performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB1","description":"ICD-MJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX54","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD1","description":"ICD-NFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1644","description":"Inj heparin sodium per 1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE1","description":"ICD-OGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF1","description":"ICD-CIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA1","description":"ICD-NDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0405","description":"HCPCS-B0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incobotulinumtoxin a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0588","description":"Incobotulinumtoxin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molecular pathology interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0452","description":"Molecular pathology interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED0","description":"ICD-AFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Slp stdy unattended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95800","description":"Slp stdy unattended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31380","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE0","description":"ICD-FHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB1","description":"ICD-JAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75741","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","description":"CPT-92636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF0","description":"ICD-PHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toilet rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0243","description":"Toilet rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF0","description":"ICD-OGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ocrelizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2350","description":"Injection_ ocrelizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF0","description":"ICD-OFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1078","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF0","description":"ICD-JAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE0","description":"ICD-NBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC1","description":"ICD-JFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB1","description":"ICD-JBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD1","description":"ICD-OBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA0","description":"ICD-GGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fc receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86243","description":"Fc receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB1","description":"ICD-FEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL31","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Er and ip hosp <2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9521","description":"Er and ip hosp <2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA0","description":"ICD-NJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF1","description":"ICD-JIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA1","description":"ICD-KEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0560","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","description":"HCPCS-G0560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES331","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rect/bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45800","description":"Repair rect/bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE1","description":"ICD-OGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD0","description":"ICD-KBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9494","description":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coupling gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4559","description":"Coupling gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA0","description":"ICD-OLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB0","description":"ICD-ECIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC1","description":"ICD-FENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0835","description":"Pwc gp2 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45560","description":"Repair of rectocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE0","description":"ICD-LIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc abd aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236T","description":"Trluml perip athrc abd aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC0","description":"ICD-NFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE1","description":"ICD-OGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC0","description":"ICD-OGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB0","description":"ICD-EGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC21","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98940","description":"Chiropract manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF0","description":"ICD-JCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68360","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE1","description":"ICD-OBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Graftjacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4107","description":"Graftjacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gold sodium thiomaleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1600","description":"Gold sodium thiomaleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No record of HBV results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9915","description":"No record of HBV results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD1","description":"ICD-GAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mitochondrial gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81440","description":"Mitochondrial gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/2.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2212","description":"Lens sphcyl bifo 7.25-12/2.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA1","description":"ICD-MJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special eye exam initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92225","description":"Special eye exam initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED0","description":"ICD-OJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF1","description":"ICD-PCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 50MCG/0.25MLBST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064A","description":"ADM SARSCOV2 50MCG/0.25MLBST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD1","description":"ICD-NLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27446","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray exam of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74210","description":"Contrst x-ray exam of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB1","description":"ICD-OEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96113","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC0","description":"ICD-AIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvf assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3020F","description":"Lvf assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ige","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82785","description":"Assay of ige","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF0","description":"ICD-OHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL55","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain image 4+ views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78605","description":"Brain image 4+ views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB0","description":"ICD-IBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA1","description":"ICD-BCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pne not given norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9280","description":"Pne not given norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92020","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF0","description":"ICD-OJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE0","description":"ICD-CFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA0","description":"ICD-KAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0566T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE0","description":"ICD-OEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB1","description":"ICD-GFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA0","description":"ICD-AHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB23","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF1","description":"ICD-NHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA1","description":"ICD-NBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD1","description":"ICD-JDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Single lens spectacle mount","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2610","description":"Single lens spectacle mount","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD0","description":"ICD-BDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB0","description":"ICD-CBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF1","description":"ICD-OJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0119","description":"Ondansetron 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC0","description":"ICD-OHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB1","description":"ICD-OGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hemorrhoid clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46320","description":"Removal of hemorrhoid clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67145","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC0","description":"ICD-NFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA0","description":"ICD-EFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0742","description":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF1","description":"ICD-DHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0C","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC1","description":"ICD-OGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE0","description":"ICD-MLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9198","description":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA1","description":"ICD-NFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD1","description":"ICD-CHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Barrera sl or barrera dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4281","description":"Barrera sl or barrera dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE0","description":"ICD-ODNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF1","description":"ICD-ECIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC1","description":"ICD-KASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Graft_ vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1768","description":"Graft_ vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61450","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA1","description":"ICD-CDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA0","description":"ICD-GCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9750","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB1","description":"ICD-CGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC0","description":"ICD-BGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD0","description":"ICD-LAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE1","description":"ICD-NBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB0","description":"ICD-MLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paliperidone palmitate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2426","description":"Paliperidone palmitate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0296","description":"Hosp bed total elect w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99326","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable liner/shield/pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4535","description":"Disposable liner/shield/pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0903","description":"HCPCS-A0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB0","description":"ICD-OLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC1","description":"ICD-BBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092U","description":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2215","description":"Pneumatic caster tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heat lamp without stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0200","description":"Heat lamp without stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7660","description":"Clsd red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of hip cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29305","description":"Application of hip cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care transport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99467","description":"Ped crit care transport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB1","description":"ICD-JCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0673","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0673","description":"HCPCS-G0673","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97035","description":"Ultrasound therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psych diag eval w/med srvcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90792","description":"Psych diag eval w/med srvcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC0","description":"ICD-OLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric bypass for obesity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43846","description":"Gastric bypass for obesity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE0","description":"ICD-BHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387T","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD0","description":"ICD-EFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation upper jaw artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30920","description":"Ligation upper jaw artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9145","description":"Injection_ daratumumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tacrolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80197","description":"Assay of tacrolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0696U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696U","description":"CPT-0696U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB1","description":"ICD-CCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME1","description":"ICD-NHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2128","description":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD230","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6058","description":"Abutment supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","description":"HCPCS-J2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31551","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF1","description":"ICD-GECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1882","description":"Aicd_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID0","description":"ICD-GAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0788","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0788","description":"HCPCS-E0788","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy w/us needle bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43232","description":"Esophagoscopy w/us needle bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB0","description":"ICD-KANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF0","description":"ICD-CCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES210","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla open reduct compound","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7710","description":"Maxilla open reduct compound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF1","description":"ICD-BENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD0","description":"ICD-KDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple surgery abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49220","description":"Multiple surgery abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hand bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25820","description":"Fusion of hand bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC1","description":"ICD-DEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex 1 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87274","description":"Herpes simplex 1 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7633","description":"Budesonide non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74018","description":"Radiologic examination_ abdomen; 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81448","description":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6233","description":"Hydrogel dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD0","description":"ICD-ACAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0468","description":"Tlso rig fram pelvic pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE1","description":"ICD-OLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF1","description":"ICD-OEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE1","description":"ICD-OKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscope procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58579","description":"Hysteroscope procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fecal microbiota prep instil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0455","description":"Fecal microbiota prep instil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB0","description":"ICD-EAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC44","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin ischemia modified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82045","description":"Albumin ischemia modified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sysrsn no dicom srch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9344","description":"Sysrsn no dicom srch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB0","description":"ICD-IFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75572","description":"Ct hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA0","description":"ICD-PFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0D","description":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB0","description":"ICD-KHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF1","description":"ICD-CEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE0","description":"ICD-OBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fixd ht w/o mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0251","description":"Hosp bed fixd ht w/o mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9983","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA1","description":"ICD-OHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyst eval trac inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9606","description":"Intraop cyst eval trac inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1mg (Portrazza)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9475","description":"Injection_ necitumumab_ 1mg (Portrazza)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD0","description":"ICD-KEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA0","description":"ICD-NFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB0","description":"ICD-KHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB235","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m aerosol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9567","description":"Technetium tc-99m aerosol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC1","description":"ICD-GDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB1","description":"ICD-DBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE0","description":"ICD-CDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam three surfaces perma","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2160","description":"Amalgam three surfaces perma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD1","description":"ICD-GCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrode stim brain add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95962","description":"Electrode stim brain add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82487","description":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DuoAmnion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4327","description":"DuoAmnion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE1","description":"ICD-LGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC0","description":"ICD-CCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB0","description":"ICD-FDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA0","description":"ICD-GILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43284","description":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro w/c cus wd<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2622","description":"Adj skin pro w/c cus wd<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0597U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","description":"CPT-0597U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC1","description":"ICD-LBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardioversion electric ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92960","description":"Cardioversion electric ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood ketone test or strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4252","description":"Blood ketone test or strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC1","description":"ICD-MIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB0","description":"ICD-KBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB1","description":"ICD-KGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB1","description":"ICD-JBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD1","description":"ICD-FIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraction erupted tooth/exr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7140","description":"Extraction erupted tooth/exr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-25448","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","description":"CPT-25448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd control bleeding any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43255","description":"Egd control bleeding any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF1","description":"ICD-FDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB0","description":"ICD-IFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE1","description":"ICD-FFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB1","description":"ICD-PBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Teniposide_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2017","description":"Teniposide_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mental status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2014F","description":"Mental status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB124","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC0","description":"ICD-BHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64907","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Free skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15757","description":"Free skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB0","description":"ICD-PFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54055","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC0","description":"ICD-KESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB1","description":"ICD-ACCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6711","description":"Ped term dev_ hook_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pyridoxine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3415","description":"Pyridoxine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC0","description":"ICD-OCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC1","description":"ICD-DAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE1","description":"ICD-NCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99393","description":"Prev visit est age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC0","description":"ICD-BFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA0","description":"ICD-PAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA0","description":"ICD-GDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal sperm detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89321","description":"Semen anal sperm detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9856","description":"Patient was not admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD1","description":"ICD-MBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB0","description":"ICD-KAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC0","description":"ICD-BFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB1","description":"ICD-NHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF1","description":"ICD-GCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hexagnal phosph pltlt neutrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85598","description":"Hexagnal phosph pltlt neutrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95984","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77787","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF1","description":"ICD-OGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA0","description":"ICD-CCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD0","description":"ICD-GBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE0","description":"ICD-GEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD0","description":"ICD-KEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME0","description":"ICD-MKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC0","description":"ICD-NKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2C","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB254","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eo rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3762","description":"Eo rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA0","description":"ICD-GEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alerting device_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5269","description":"Alerting device_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculation shell via","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87254","description":"Virus inoculation shell via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD1","description":"ICD-LHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA1","description":"ICD-NILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF0","description":"ICD-JDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93797","description":"Cardiac rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF1","description":"ICD-BIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0250U","description":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA0","description":"ICD-AELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB1","description":"ICD-MLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD1","description":"ICD-ODXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD0","description":"ICD-JEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE1","description":"ICD-EDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE0","description":"ICD-OJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF1","description":"ICD-CHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB1","description":"ICD-DGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND1","description":"ICD-FBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF1","description":"ICD-EABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2599","description":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC1","description":"ICD-NIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC0","description":"ICD-GBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID0","description":"ICD-NJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD1","description":"ICD-NFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB0","description":"ICD-CGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX10","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC0","description":"ICD-IGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11471","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC1","description":"ICD-DIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB0","description":"ICD-JANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC0","description":"ICD-OBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37239","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing loss dup/del analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81431","description":"Hearing loss dup/del analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD0","description":"ICD-MGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0503","description":"HCPCS-C0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optimal care for patients with episodic neurological conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0003","description":"Optimal care for patients with episodic neurological conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX06","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD0","description":"ICD-AEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA0","description":"ICD-CHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90682","description":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE0","description":"ICD-CABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81411","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13121","description":"Cmplx rpr s/a/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF0","description":"ICD-CGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC1","description":"ICD-GIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95071","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC1","description":"ICD-BCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB0","description":"ICD-CAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC0","description":"ICD-CDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25415","description":"Repair radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB0","description":"ICD-LBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA0","description":"ICD-ODUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0803T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57330","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC220","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoelectrophoresis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86327","description":"Immunoelectrophoresis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC0","description":"ICD-OHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55862","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0211","description":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2309","description":"Lens sphc trifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55815","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin buttck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15835","description":"Excise excessive skin buttck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97608","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88029","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC1","description":"ICD-BHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25449","description":"Remove wrist joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA1","description":"ICD-CHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF1","description":"ICD-BHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95146","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC1","description":"ICD-PESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB1","description":"ICD-NKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB0","description":"ICD-BBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF0","description":"ICD-FAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81348","description":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB0","description":"ICD-GIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA0","description":"ICD-AEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"corticotomy - four or more teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7297","description":"corticotomy - four or more teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE0","description":"ICD-DGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA1","description":"ICD-NJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd varices ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43244","description":"Egd varices ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test one fiber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95872","description":"Muscle test one fiber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB0","description":"ICD-KGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA1","description":"ICD-CFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57284","description":"Repair paravag defect open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59135","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA1","description":"ICD-OFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33261","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9562","description":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341U","description":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC0","description":"ICD-FDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE0","description":"ICD-IHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag ctr rigi pos pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0643","description":"Lso sag ctr rigi pos pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1248","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1270","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35276","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE0","description":"ICD-PBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2175","description":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Swallow goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8997","description":"Swallow goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53415","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80416","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC0","description":"ICD-KCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF1","description":"ICD-ODDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC1","description":"ICD-FHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD0","description":"ICD-KITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27450","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC1","description":"ICD-FFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB0","description":"ICD-NGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA0","description":"ICD-GHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB1","description":"ICD-NAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20103","description":"Explore wound extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6099","description":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC216","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF0","description":"ICD-FIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA0","description":"ICD-JHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA1","description":"ICD-NIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lysis of labial lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56441","description":"Lysis of labial lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE1","description":"ICD-GAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB0","description":"ICD-MFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND0","description":"ICD-OEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE1","description":"ICD-IGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29901","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA1","description":"ICD-GGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF0","description":"ICD-NCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF0","description":"ICD-KDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF0","description":"ICD-FATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33305","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB0","description":"ICD-KEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID0","description":"ICD-JGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA0","description":"ICD-OFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC0","description":"ICD-MJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repriza_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4143","description":"Repriza_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3D","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF1","description":"ICD-NAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endocrine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60699","description":"Endocrine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF1","description":"ICD-CCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB0","description":"ICD-KIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES212","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD0","description":"ICD-IFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE1","description":"ICD-FCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA0","description":"ICD-BGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27120","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood clot retraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85170","description":"Blood clot retraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22903","description":"Exc abd les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA0","description":"ICD-GFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA1","description":"ICD-FEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0026U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01150","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","description":"CPT-01150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC0","description":"ICD-LBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rgd ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1237","description":"Rgd ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD0","description":"ICD-NGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreserve stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38207","description":"Cryopreserve stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF0","description":"ICD-GBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE246","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9771","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74450","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stat lab home/nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3601","description":"Stat lab home/nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF0","description":"ICD-JHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Off assis eol iss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9380","description":"Off assis eol iss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF1","description":"ICD-AATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46611","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD0","description":"ICD-JHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA1","description":"ICD-KIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD1","description":"ICD-CCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB1","description":"ICD-CIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0502","description":"HCPCS-A0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA1","description":"ICD-OLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC1","description":"ICD-EGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15773","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97530","description":"Therapeutic activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnenolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84140","description":"Assay of pregnenolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation shield","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5984","description":"Radiation shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25040","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD1","description":"ICD-OBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ allopurinol sodium_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0206","description":"Injection_ allopurinol sodium_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA30","description":"High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE0","description":"ICD-NDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84583","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA0","description":"ICD-OBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF1","description":"ICD-IFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genetic testing als","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3800","description":"Genetic testing als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90963","description":"Esrd home pt serv p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70210","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC1","description":"ICD-FCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB0","description":"ICD-NEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5D","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlh w/t/o uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58573","description":"Tlh w/t/o uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF1","description":"ICD-PEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD1","description":"ICD-OAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC1","description":"ICD-NAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE1","description":"ICD-KBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF1","description":"ICD-FFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD0","description":"ICD-GFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35571","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE1","description":"ICD-MHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC0","description":"ICD-BGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE1","description":"ICD-NLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE0","description":"ICD-FAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB1","description":"ICD-CAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE1","description":"ICD-NGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC0","description":"ICD-GIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41113","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF0","description":"ICD-FHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID1","description":"ICD-OFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80192","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB54","description":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB1","description":"ICD-CCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone harvest_auto graft proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7295","description":"Bone harvest_auto graft proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC0","description":"ICD-IACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA0","description":"ICD-KGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Panoramic x-ray of jaws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70355","description":"Panoramic x-ray of jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43116","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF1","description":"ICD-OEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF0","description":"ICD-BEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self care current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8987","description":"Self care current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme histochemistry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88319","description":"Enzyme histochemistry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC1","description":"ICD-NICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD1","description":"ICD-CGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whchr h-duty det arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1280","description":"Whchr h-duty det arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID0","description":"ICD-OHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth testis suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93051","description":"Anesth testis suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiological examination_ surgical specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76098","description":"Radiological examination_ surgical specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vincristine sulfate 1 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9370","description":"Vincristine sulfate 1 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA1","description":"ICD-JGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic join","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5696","description":"Ak/knee disartic pelvic join","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","description":"HCPCS-M1378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wnd prep f/n/hf/g addl cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15005","description":"Wnd prep f/n/hf/g addl cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1829","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","description":"HCPCS-E1829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME0","description":"ICD-IFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB0","description":"ICD-MCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle control ortho pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4350","description":"Ankle control ortho pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8A","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA0","description":"ICD-IABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28222","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA1","description":"ICD-KABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth 60 min/> as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4255F","description":"Anesth 60 min/> as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9139","description":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0913T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","description":"CPT-0913T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB0","description":"ICD-FAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31632","description":"Bronchoscopy/lung bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC0","description":"ICD-OLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD1","description":"ICD-GATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 52-73 gm prot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4193","description":"Parenteral sol 52-73 gm prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28495","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF0","description":"ICD-KEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA1","description":"ICD-CHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC1","description":"ICD-GDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","description":"CPT-00868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF1","description":"ICD-GCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC1","description":"ICD-NFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA1","description":"ICD-LASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE1","description":"ICD-CAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Translum dil eye canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66174","description":"Translum dil eye canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD1","description":"ICD-JGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9259","description":"Doc surv no stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8936","description":"Mra_ w/o&w/dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF1","description":"ICD-EFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC1","description":"ICD-IBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF1","description":"ICD-BGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39540","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for urethra pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53240","description":"Surgery for urethra pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA0","description":"ICD-GIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9277","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","description":"HCPCS-J9277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4542","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1734","description":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC0","description":"ICD-GFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA0","description":"ICD-IEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA31","description":"ICD-3AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33949","description":"Ecmo/ecls daily mgmt artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE0","description":"ICD-HHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA1","description":"ICD-GAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB1","description":"ICD-CFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung ventilation imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78579","description":"Lung ventilation imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC0","description":"ICD-CAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53460","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78018","description":"Thyroid met imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49600","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zidovudine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3485","description":"Zidovudine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE1","description":"ICD-GFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC0","description":"ICD-GAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB1","description":"ICD-MCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","description":"CPT-01620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE0","description":"ICD-IFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE1","description":"ICD-AILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99252","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC0","description":"ICD-KCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD1","description":"ICD-BEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7659","description":"Isoproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC0","description":"ICD-OBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decitabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0894","description":"Decitabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF1","description":"ICD-METF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1dose menig vac btwn 11 & 13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9414","description":"1dose menig vac btwn 11 & 13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In hospice or using hospice services during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1167","description":"In hospice or using hospice services during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE1","description":"ICD-KEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26852","description":"Fusion of knuckle with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC0","description":"ICD-GEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE0","description":"ICD-GFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC1","description":"ICD-PLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB31","description":"ICD-3DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0555U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","description":"CPT-0555U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Thrombosis Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278U","description":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Thrombosis Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD1","description":"ICD-GGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1840","description":"Kanamycin sulfate 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alveoplasty w/o extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7320","description":"Alveoplasty w/o extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE0","description":"ICD-OKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB1","description":"ICD-PKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED0","description":"ICD-MJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC0","description":"ICD-KHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl icar ischm mntrng dvce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307T","description":"Rmvl icar ischm mntrng dvce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB1","description":"ICD-PKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9465","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB1","description":"ICD-KCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE0","description":"ICD-CGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl <11 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3281F","description":"Hgb lvl <11 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29867","description":"Allgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA40","description":"Low Rehab_ ADL Index 0-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8599","description":"No asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF1","description":"ICD-CAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA0","description":"ICD-LAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE1","description":"ICD-JAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA1","description":"ICD-FGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA31","description":"ICD-4FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5710","description":"Dentures rebase cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF0","description":"ICD-OAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA0","description":"ICD-GFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE0","description":"ICD-GCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80500","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA0","description":"ICD-FADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8X","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC11","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF0","description":"ICD-JCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35001","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA0","description":"ICD-OKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41828","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB0","description":"ICD-OGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long qt syn gene dup/dlt var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81282","description":"Long qt syn gene dup/dlt var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","description":"CPT-00840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE1","description":"ICD-GAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA1","description":"ICD-KBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids quant 2-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82136","description":"Amino acids quant 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81408","description":"Mopath procedure level 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/implant finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26536","description":"Revise/implant finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC0","description":"ICD-PERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0589","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Christian sci pract visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9900","description":"Christian sci pract visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE1","description":"ICD-BHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC0","description":"ICD-GEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD0","description":"ICD-CGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB0","description":"ICD-OKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF0","description":"ICD-KHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD1","description":"ICD-GFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF1","description":"ICD-MFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC0","description":"ICD-EFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor four anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81511","description":"Ftl cgen abnor four anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF1","description":"ICD-LFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE226","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23665","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0603","description":"HCPCS-A0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE0","description":"ICD-OCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7530","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7530","description":"HCPCS-J7530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0716T","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC0","description":"ICD-KEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED1","description":"ICD-JHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD1","description":"ICD-JGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD1","description":"ICD-FFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing patient serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86904","description":"Blood typing patient serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE1","description":"ICD-LEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED1","description":"ICD-KGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF0","description":"ICD-NIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare embryo for transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89255","description":"Prepare embryo for transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ire abltj 1+tum organ perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0600T","description":"Ire abltj 1+tum organ perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC1","description":"ICD-KDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 4 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0400","description":"Home sleep test/type 4 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlorambucil 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0172","description":"Chlorambucil 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF0","description":"ICD-JAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD0","description":"ICD-ADBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag rigid frame cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0632","description":"Lso sag rigid frame cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guide nerv destr needle emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95874","description":"Guide nerv destr needle emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE0","description":"ICD-MHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC0","description":"ICD-BHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD0","description":"ICD-CHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC1","description":"ICD-NHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition of walker to cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29440","description":"Addition of walker to cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 19 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP19","description":"Auto test panel pricing code_ 19 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB251","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD0","description":"ICD-NFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC0","description":"ICD-MKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE1","description":"ICD-BBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29804","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA1","description":"ICD-LIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydroceles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55041","description":"Removal of hydroceles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21600","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD0","description":"ICD-BALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC0","description":"ICD-BDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB0","description":"ICD-JHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA1","description":"ICD-NIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64742","description":"Incision of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treated water per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4714","description":"Treated water per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Max ultrasound image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0386","description":"Max ultrasound image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF0","description":"ICD-KDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD0","description":"ICD-FGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF0","description":"ICD-CIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec alys vagus nrv pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317T","description":"Elec alys vagus nrv pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1042T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1042T","description":"CPT-1042T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E2403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2403","description":"HCPCS-E2403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA1","description":"ICD-NHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA0","description":"ICD-KITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA0","description":"ICD-NEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA1","description":"ICD-FEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penile venous occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37790","description":"Penile venous occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible mlc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87187","description":"Microbe susceptible mlc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA0","description":"ICD-NCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF1","description":"ICD-OJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF1","description":"ICD-BCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"B-12 binding capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82608","description":"B-12 binding capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0598T","description":"Ncntc r-t fluor wnd img 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57500","description":"Biopsy of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8I","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA1","description":"ICD-OGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin test nos antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86486","description":"Skin test nos antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4B","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS or NRAS) gene mutation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9843","description":"RAS (KRAS or NRAS) gene mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32100","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical stent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5982","description":"Surgical stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2090","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier solid 4x4 equiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4372","description":"Skin barrier solid 4x4 equiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum dep 5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27339","description":"Exc thigh/knee tum dep 5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA246","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound cleanser any type/size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6260","description":"Wound cleanser any type/size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2272","description":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB0","description":"ICD-HHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB1","description":"ICD-IBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD0","description":"ICD-KELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt brain chemotx add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61517","description":"Implt brain chemotx add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-disposable underpads_ all sizes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4553","description":"Non-disposable underpads_ all sizes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1390","description":"Oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50436","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic shoe w/roller/rockr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5503","description":"Diabetic shoe w/roller/rockr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317U","description":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD0","description":"ICD-CCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microprcsr cu elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0481","description":"Microprcsr cu elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF0","description":"ICD-EGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast based metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6781","description":"Crown 3/4 cast based metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC0","description":"ICD-KCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9307","description":"HCPCS-C9307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF1","description":"ICD-NKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us guide intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76998","description":"Us guide intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch substitute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0118","description":"Crutch substitute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB1","description":"ICD-ODTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA1","description":"ICD-NATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD1","description":"ICD-MAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB1","description":"ICD-CHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87511","description":"Gardner vag dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB0","description":"ICD-FDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC1","description":"ICD-OAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code 13-16 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP16","description":"Auto test panel pricing code 13-16 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27334","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX25","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID1","description":"ICD-OEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE1","description":"ICD-KGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD250","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0508U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0508U","description":"CPT-0508U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC0","description":"ICD-JEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF0","description":"ICD-OLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF1","description":"ICD-HFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB0","description":"ICD-HDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB1","description":"ICD-LASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove kidney open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50220","description":"Remove kidney open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26123","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tretinoin topical 5 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0117","description":"Tretinoin topical 5 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF0","description":"ICD-NHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8010","description":"Mastectomy sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA0","description":"ICD-GEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA20","description":"High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52305","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF1","description":"ICD-ODSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neuro non-recharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1767","description":"Generator_ neuro non-recharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cerv artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22864","description":"Remove cerv artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC0","description":"ICD-OJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD1","description":"ICD-KCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB0","description":"ICD-OHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove nail bed/tip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11752","description":"Remove nail bed/tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE1","description":"ICD-GINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE1","description":"ICD-FBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD0","description":"ICD-GEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0506T","description":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB1","description":"ICD-PEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD1","description":"ICD-BBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC1","description":"ICD-CDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA0","description":"ICD-KCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD0","description":"ICD-NIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD0","description":"ICD-OBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; subdural taps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0131U","description":"Anesthesia for intracranial procedures; subdural taps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML21","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental recement bridge","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6930","description":"Dental recement bridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC1","description":"ICD-JDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35566","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - motivational interviewing","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9993","description":"Dental case management - motivational interviewing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535F","description":"Dyspnea mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1003","description":"CDT-D1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD1","description":"ICD-FAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML35","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC1","description":"ICD-KHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE1","description":"ICD-OACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA0","description":"ICD-LBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC1","description":"ICD-NBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47711","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC1","description":"ICD-KIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 2 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34846","description":"Visc & infraren abd 2 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB1","description":"ICD-MLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC0","description":"ICD-LEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE0","description":"ICD-OAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lactic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83605","description":"Assay of lactic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical testimony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99075","description":"Medical testimony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (lh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83002","description":"Assay of gonadotropin (lh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sotrovimab_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0247","description":"Injection_ sotrovimab_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB0","description":"ICD-KHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47451","description":"Anesth surgery of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5878","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5878","description":"CDT-D5878","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9355","description":"No early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB1","description":"ICD-CHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject congenital card cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93563","description":"Inject congenital card cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF1","description":"ICD-CCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5138","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF1","description":"ICD-BGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27130","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","description":"HCPCS-Q4428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ trans atherectomy_ dir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1714","description":"Cath_ trans atherectomy_ dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31775","description":"Reconstruct bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3503","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD0","description":"ICD-JFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3761","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL03","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9833","description":"Patient transfer to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50650","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA0","description":"ICD-OFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD1","description":"ICD-CFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC0","description":"ICD-NDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plague vaccine_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90727","description":"Plague vaccine_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC1","description":"ICD-FIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frozen cell preparation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88241","description":"Frozen cell preparation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0810T","description":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC1","description":"ICD-GHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC1","description":"ICD-JBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA1","description":"ICD-FDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC0","description":"ICD-OEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63172","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB0","description":"ICD-NETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hair removal by electrolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17380","description":"Hair removal by electrolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace strap_ any orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4002","description":"Replace strap_ any orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF0","description":"ICD-AACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release thumb contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26508","description":"Release thumb contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC0","description":"ICD-KFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA1","description":"ICD-DCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA1","description":"ICD-GAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA1","description":"ICD-AABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetes prev standard curr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403T","description":"Diabetes prev standard curr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF0","description":"ICD-JICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC0","description":"ICD-CDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interventional Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4012","description":"Interventional Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX14","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA1","description":"ICD-GGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA0","description":"ICD-BAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC221","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA0","description":"ICD-NLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dsm-5 info mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1040F","description":"Dsm-5 info mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB1","description":"ICD-EIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93281","description":"Pm device progr eval multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA256","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE1","description":"ICD-FDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug hotline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0030","description":"Alcohol and/or drug hotline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD1","description":"ICD-KDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357T","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular function screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99172","description":"Ocular function screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62304","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc taa repr w/o subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33881","description":"Endovasc taa repr w/o subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93248","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE1","description":"ICD-OKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA0","description":"ICD-BHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE1","description":"ICD-GAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE0","description":"ICD-KDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9779","description":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87470","description":"Bartonella dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA1","description":"ICD-OGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25810","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA0","description":"ICD-HCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD1","description":"ICD-FIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42140","description":"Excision of uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gentamicin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80170","description":"Assay of gentamicin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36223","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc stage docd b/4 thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3300F","description":"Ajcc stage docd b/4 thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anticoag clinic per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9401","description":"Anticoag clinic per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF0","description":"ICD-NHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID1","description":"ICD-AAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenytoin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80185","description":"Assay of phenytoin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF0","description":"ICD-OJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inversion/eversion correction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9285","description":"Inversion/eversion correction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC0","description":"ICD-KHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB0","description":"ICD-GEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0137","description":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB1","description":"ICD-OFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF0","description":"ICD-BIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF0","description":"ICD-MIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE1","description":"ICD-OENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Giardia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87269","description":"Giardia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC1","description":"ICD-HDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF0","description":"ICD-FHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA1","description":"ICD-AHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27391","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of transferrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84466","description":"Assay of transferrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF0","description":"ICD-CAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA0","description":"ICD-EDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC44","description":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev auto grasp feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6881","description":"Term dev auto grasp feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD236","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD0","description":"ICD-GDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC0","description":"ICD-LIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2 noprogres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9072","description":"Onc dx brst stg1-2 noprogres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB21","description":"ICD-4JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB145","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD0","description":"ICD-OAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - complete series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0709","description":"Intraoral - complete series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9152","description":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES231","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB1","description":"ICD-JECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB0","description":"ICD-GAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF1","description":"ICD-NGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kit gene targeted seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81272","description":"Kit gene targeted seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF1","description":"ICD-KAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86975","description":"Rbc serum pretx incubj drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD1","description":"ICD-MDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF0","description":"ICD-BACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC141","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3D","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC0","description":"ICD-JDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst base mtl >=3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6613","description":"Onlay cst base mtl >=3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17106","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78802","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1339","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB02","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF0","description":"ICD-GHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC0","description":"ICD-FAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA1","description":"ICD-LCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF1","description":"ICD-GHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC205","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii typing lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81370","description":"Hla i & ii typing lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heel spur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28119","description":"Removal of heel spur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE0","description":"ICD-KCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nutrition class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9452","description":"Nutrition class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0C","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE1","description":"ICD-PFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC0","description":"ICD-OBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF1","description":"ICD-CHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE0","description":"ICD-BGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tract equip cervical tract","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0860","description":"Tract equip cervical tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB0","description":"ICD-KEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft 2 veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35682","description":"Composite byp grft 2 veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB0","description":"ICD-MEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Head control interface mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2327","description":"Head control interface mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA0","description":"ICD-OEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detach adjust armrst upper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0018","description":"Detach adjust armrst upper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF0","description":"ICD-BEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA0","description":"ICD-OCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dactinomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9120","description":"Dactinomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF1","description":"ICD-KANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6180","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6180","description":"CDT-D6180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl& replc pulse gen 1 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33262","description":"Rmvl& replc pulse gen 1 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD1","description":"ICD-JIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp 5yrs/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99144","description":"Mod sedat phys/qhp 5yrs/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB0","description":"ICD-FBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA0","description":"ICD-OIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA1","description":"ICD-OAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74270","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB0","description":"ICD-GEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64620","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF1","description":"ICD-OCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB51","description":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME1","description":"ICD-EHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC246","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ omacetaxine mep_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9262","description":"Inj_ omacetaxine mep_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA0","description":"ICD-BAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE1","description":"ICD-CCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB1","description":"ICD-PLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA0","description":"ICD-OHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE1","description":"ICD-DEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF0","description":"ICD-OJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB1","description":"ICD-KDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC1","description":"ICD-BGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA0","description":"ICD-NEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c shoulder harness/straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0960","description":"W/c shoulder harness/straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not achieve flat retinas six months post surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9379","description":"Patient did not achieve flat retinas six months post surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37294","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","description":"CPT-37294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD1","description":"ICD-JIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF0","description":"ICD-IBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX24","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB0","description":"ICD-FCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Packing strips_ non-impreg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6407","description":"Packing strips_ non-impreg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hizentra injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1559","description":"Hizentra injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair pt wt >300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1039","description":"Transport chair pt wt >300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA1","description":"ICD-GFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE0","description":"ICD-CFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal monitor w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59050","description":"Fetal monitor w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC30","description":"High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0521U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","description":"CPT-0521U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Slp stdy unatnd w/anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95801","description":"Slp stdy unatnd w/anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB0","description":"ICD-OEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA0","description":"ICD-OIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED0","description":"ICD-IIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lateral trochanteric pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1290","description":"Lateral trochanteric pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC201","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucose tolerance test (gtt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82951","description":"Glucose tolerance test (gtt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Co/membane diffuse capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94729","description":"Co/membane diffuse capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prostate ca screening; dre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0102","description":"Prostate ca screening; dre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC0","description":"ICD-JAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA0","description":"ICD-CABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB220","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA0","description":"ICD-CHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65800","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF1","description":"ICD-NHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of end stage renal disease (esrd)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1187","description":"Patients with a diagnosis of end stage renal disease (esrd)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC1","description":"ICD-OJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND0","description":"ICD-JCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0583U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","description":"CPT-0583U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC0","description":"ICD-DIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB0","description":"ICD-OIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43202","description":"Esophagoscopy flex biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB1","description":"ICD-OLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37261","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","description":"CPT-37261","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA1","description":"ICD-NEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX60","description":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD1","description":"ICD-CCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC1","description":"ICD-CAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC1","description":"ICD-EDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0069U","description":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lap enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83670","description":"Assay of lap enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rozanolixizumab-noli_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9333","description":"Injection_ rozanolixizumab-noli_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF1","description":"ICD-GBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82565","description":"Assay of creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB1","description":"ICD-GGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA0","description":"ICD-GIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE0","description":"ICD-NJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sps wrist device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1806","description":"Sps wrist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB0","description":"ICD-MKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD1","description":"ICD-BEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE0","description":"ICD-EEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89250","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01340","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","description":"CPT-01340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelogphy 2/> spine regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72270","description":"Myelogphy 2/> spine regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of collarbone joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23106","description":"Incision of collarbone joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF0","description":"ICD-FFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0103","description":"HCPCS-C0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muramidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85549","description":"Muramidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC1","description":"ICD-ACUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC0","description":"ICD-NKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD1","description":"ICD-KEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB1","description":"ICD-BIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD1","description":"ICD-EAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB1","description":"ICD-CDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC1","description":"ICD-AAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF0","description":"ICD-AGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0702","description":"HCPCS-A0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodener muscle larynx emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64617","description":"Chemodener muscle larynx emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC1","description":"ICD-FFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE1","description":"ICD-GCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB1","description":"ICD-KBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA0","description":"ICD-NFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA0","description":"ICD-KCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB11","description":"ICD-2LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB1","description":"ICD-JFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted misc prosthetic ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8499","description":"Unlisted misc prosthetic ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain alg alys data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0611T","description":"Mrs disc pain alg alys data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE0","description":"ICD-MBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92542","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB1","description":"ICD-GDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1st course antitnf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8868","description":"1st course antitnf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ag detection polyval if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87300","description":"Ag detection polyval if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB0","description":"ICD-OATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF0","description":"ICD-OFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA1","description":"ICD-BICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC1","description":"ICD-JFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9466","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4D","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF0","description":"ICD-JHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB0","description":"ICD-EBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1124","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD0","description":"ICD-FFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB31","description":"ICD-3LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imterprete diagnostic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0391","description":"Imterprete diagnostic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD0","description":"ICD-AGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED0","description":"ICD-NBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glasses air conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5070","description":"Glasses air conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC0","description":"ICD-JDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL14","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE1","description":"ICD-NADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD0","description":"ICD-OEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c rna done prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9203","description":"Hep c rna done prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB1","description":"ICD-CELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA0","description":"ICD-OBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE0","description":"ICD-DARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD0","description":"ICD-OFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD1","description":"ICD-OHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC0","description":"ICD-ACBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0678T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB1","description":"ICD-OHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66625","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA0","description":"ICD-MGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens gas permbl bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2512","description":"Cntct lens gas permbl bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC0","description":"ICD-OFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD1","description":"ICD-OEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL52","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE0","description":"ICD-NDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED1","description":"ICD-GEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC0","description":"ICD-JCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval risk vte card 30d prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9298","description":"Eval risk vte card 30d prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB0","description":"ICD-JDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB0","description":"ICD-NKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA1","description":"ICD-OEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF0","description":"ICD-OFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD1","description":"ICD-OLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC0","description":"ICD-JAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575F","description":"Hiv rna plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE1","description":"ICD-GGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB1","description":"ICD-OIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC0","description":"ICD-GDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC1","description":"ICD-OILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC1","description":"ICD-OATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4366","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","description":"HCPCS-Q4366","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF1","description":"ICD-KETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF0","description":"ICD-ICMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF1","description":"ICD-OFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC1","description":"ICD-MIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD1","description":"ICD-JCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB1","description":"ICD-KFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC0","description":"ICD-NHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0916","description":"Satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA1","description":"ICD-HEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5924","description":"Cranial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck m1 mets rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9111","description":"Onc dx head/neck m1 mets rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flu immuno admind rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4274F","description":"Flu immuno admind rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB1","description":"ICD-KBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC0","description":"ICD-CEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8721","description":"HCPCS-L8721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8009","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8009","description":"HCPCS-C8009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE0","description":"ICD-GAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF1","description":"ICD-NLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Octreotide injection_ depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2353","description":"Octreotide injection_ depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB0","description":"ICD-JGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4271","description":"Complete ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alternating pressure pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4640","description":"Alternating pressure pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF0","description":"ICD-OLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF1","description":"ICD-JBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB1","description":"ICD-FBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB1","description":"ICD-CAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise max/zygoma mal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21034","description":"Excise max/zygoma mal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methadone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6053","description":"Methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31395","description":"Reconstruct larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow child myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7191","description":"Elbow child myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA255","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB0","description":"ICD-OJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0605","description":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB1","description":"ICD-IHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC1","description":"ICD-ODOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA0","description":"ICD-KFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC0","description":"ICD-BDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/deb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29906","description":"Subtalar arthro w/deb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB1","description":"ICD-KIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC1","description":"ICD-KHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF0","description":"ICD-NFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF0","description":"ICD-BAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD0","description":"ICD-LCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0585U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","description":"CPT-0585U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE1","description":"ICD-MAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF0","description":"ICD-GFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC0","description":"ICD-IDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92081","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93898","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","description":"CPT-93898","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE0","description":"ICD-OIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA0","description":"ICD-OAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9173","description":"HCPCS-C9173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME1","description":"ICD-CCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA0","description":"ICD-OLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16251","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73080","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF1","description":"ICD-AIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal lamina add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63048","description":"Remove spinal lamina add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lith-ion batt elec/pneum vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0506","description":"Lith-ion batt elec/pneum vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB1","description":"ICD-NEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33929","description":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FlowerAmnioFlo_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4177","description":"FlowerAmnioFlo_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC1","description":"ICD-CEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID0","description":"ICD-NGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF0","description":"ICD-FFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA1","description":"ICD-OCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA0","description":"ICD-MCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE0","description":"ICD-GHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96370","description":"Sc ther infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB1","description":"ICD-LIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0879T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24577","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD0","description":"ICD-NCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1735","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1735","description":"HCPCS-C1735","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9146","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE154","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal flow sheet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501F","description":"Prenatal flow sheet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0633U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0633U","description":"CPT-0633U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD0","description":"ICD-OFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA1","description":"ICD-FCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF1","description":"ICD-CAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF1","description":"ICD-CIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9715","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB0","description":"ICD-OHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE1","description":"ICD-GBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7212","description":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urgent care center global","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9083","description":"Urgent care center global","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE0","description":"ICD-JDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE1","description":"ICD-GIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB0","description":"ICD-NKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA0","description":"ICD-GCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC0","description":"ICD-IIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vancomycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80202","description":"Assay of vancomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF0","description":"ICD-JBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tb intradermal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86580","description":"Tb intradermal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64598","description":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA0","description":"ICD-FFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC1","description":"ICD-JHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB0","description":"ICD-BFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81364","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF1","description":"ICD-OHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD0","description":"ICD-OALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC1","description":"ICD-GIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reas no adhere pos air pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8854","description":"Reas no adhere pos air pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC11","description":"ICD-4DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8651","description":"Fun stat score hip >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC1","description":"ICD-BBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3214","description":"Benesch boot pair junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped caloric dense>/=0.7kc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4160","description":"Ef ped caloric dense>/=0.7kc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD0","description":"ICD-IHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB1","description":"ICD-MIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9999","description":"Adjunctive procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF1","description":"ICD-FIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ciliary transsleral therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66710","description":"Ciliary transsleral therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF1","description":"ICD-OASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE1","description":"ICD-JHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0129","description":"Abatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg elb dis/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6382","description":"Postop dsg cast chg elb dis/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE0","description":"ICD-FBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial four or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33536","description":"Cabg arterial four or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16073","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16073","description":"CPT-16073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2117","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray male genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74440","description":"X-ray male genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath subclavian art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36225","description":"Place cath subclavian art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA1","description":"ICD-BDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0665","description":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA0","description":"ICD-CGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE1","description":"ICD-KCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4217","description":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF1","description":"ICD-FCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA0","description":"ICD-CDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF0","description":"ICD-BHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE0","description":"ICD-PLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29720","description":"Repair of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB0","description":"ICD-PFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj facial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64402","description":"N block inj facial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC1","description":"ICD-GBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA0","description":"ICD-OAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76705","description":"Echo exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA0","description":"ICD-AEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86835","description":"Hla class ii semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA1","description":"ICD-MGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht hem horm inj diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9537","description":"Ht hem horm inj diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX45","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF0","description":"ICD-BEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26121","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB0","description":"ICD-ODGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93282","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD1","description":"ICD-FCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2A","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF1","description":"ICD-JDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Current tobacco smoker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1034F","description":"Current tobacco smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC1","description":"ICD-KBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD155","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD1","description":"ICD-JGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8007","description":"HCPCS-C8007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF0","description":"ICD-HBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF1","description":"ICD-CCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0924T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","description":"CPT-0924T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5131","description":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE0","description":"ICD-DGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC0","description":"ICD-IIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6213","description":"Foam drg >16<=48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylergonovin maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2210","description":"Methylergonovin maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin alfa_ 100 units esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4081","description":"Epoetin alfa_ 100 units esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachy linear_ non-str_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2636","description":"Brachy linear_ non-str_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202U","description":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA0","description":"ICD-NJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC0","description":"ICD-LIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND1","description":"ICD-OEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cptr-asst dir ms px","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20985","description":"Cptr-asst dir ms px","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair diaphragm laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39501","description":"Repair diaphragm laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD1","description":"ICD-JCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF0","description":"ICD-GBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB226","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE0","description":"ICD-NAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quant nonher2 ihc brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3395F","description":"Quant nonher2 ihc brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21480","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF0","description":"ICD-BCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2088","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440T","description":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF0","description":"ICD-KCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6686","description":"Suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD0","description":"ICD-AHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert 2 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33217","description":"Insert 2 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE0","description":"ICD-CAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/bx & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31536","description":"Laryngoscopy w/bx & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9159","description":"Lang comp current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Near ifr spectrsc of wounds","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286T","description":"Near ifr spectrsc of wounds","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2711","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","description":"HCPCS-J2711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB1","description":"ICD-NKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC0","description":"ICD-EATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC0","description":"ICD-FHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB0","description":"ICD-LHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97799","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx bipol_ death_ nhres_ hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9394","description":"Dx bipol_ death_ nhres_ hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE0","description":"ICD-GDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retr bone flap to fix skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62148","description":"Retr bone flap to fix skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rubella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86762","description":"Rubella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA116","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA0","description":"ICD-LGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB0","description":"ICD-BFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB1","description":"ICD-NGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59855","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening; blood-based biomarker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0327","description":"Colorectal cancer screening; blood-based biomarker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vision svcs frames purchases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2020","description":"Vision svcs frames purchases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath emboliz microspher","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2095","description":"Transcath emboliz microspher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adenosine inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0153","description":"Adenosine inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54111","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE1","description":"ICD-OHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine specimen collect mult","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9615","description":"Urine specimen collect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3C","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD0","description":"ICD-HDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0902","description":"CDT-D0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF1","description":"ICD-OEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72127","description":"Ct neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE1","description":"ICD-MBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA0","description":"ICD-KCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80430","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE0","description":"ICD-GCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70450","description":"Ct head/brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-n3 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9215","description":"Interferon alfa-n3 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA1","description":"ICD-GEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft peri per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3428","description":"Bone graft peri per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF0","description":"ICD-ICLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0865T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF0","description":"ICD-OHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ibuprofen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1741","description":"Ibuprofen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AI IBD MRNA XPRSN PRFL 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0203U","description":"AI IBD MRNA XPRSN PRFL 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cell enumeration & id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86152","description":"Cell enumeration & id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB1","description":"ICD-HGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE0","description":"ICD-EDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject for sacroiliac joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0259","description":"Inject for sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF0","description":"ICD-DEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palatal lift prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5955","description":"Palatal lift prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD1","description":"ICD-LEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dent appl desensitizing med","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9910","description":"Dent appl desensitizing med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA1","description":"ICD-DFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee jnt ratchet lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2430","description":"Knee jnt ratchet lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj hi_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9003","description":"Mccd_ risk adj hi_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC0","description":"ICD-IGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23802","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA1","description":"ICD-FFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA0","description":"ICD-FCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1225","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA0","description":"ICD-IGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of abdominal wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49900","description":"Repair of abdominal wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86294","description":"Immunoassay tumor qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9036","description":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA0","description":"ICD-JGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1137F","description":"Epsd bk pain for >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB0","description":"ICD-JAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81277","description":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","description":"CPT-98014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA42","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB0","description":"ICD-JCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF0","description":"ICD-PCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF0","description":"ICD-KAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD0","description":"ICD-LIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC1","description":"ICD-OBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA1","description":"ICD-PLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Port_ indwelling_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1788","description":"Port_ indwelling_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC17","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC1","description":"ICD-GHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8704","description":"Replacement Of Lost Or Broken Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF0","description":"ICD-CBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Odontics transosteal implnt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6050","description":"Odontics transosteal implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE1","description":"ICD-HIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init bk ptb plaster direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5500","description":"Init bk ptb plaster direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent repair of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64872","description":"Subsequent repair of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC1","description":"ICD-IALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD0","description":"ICD-CASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36800","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB0","description":"ICD-NFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC1","description":"ICD-NJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81410","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC1","description":"ICD-BFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE0","description":"ICD-NHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA1","description":"ICD-EDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC0","description":"ICD-GCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28047","description":"Resect foot/toe tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE0","description":"ICD-MKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB0","description":"ICD-OIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA1","description":"ICD-NIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray stereo frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71015","description":"Chest x-ray stereo frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC0","description":"ICD-NIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF0","description":"ICD-CGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67915","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2166","description":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC1","description":"ICD-KCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB0","description":"ICD-JEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA0","description":"ICD-AILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onco (ovar) five proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81503","description":"Onco (ovar) five proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC1","description":"ICD-HIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 2vw frontal&latl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71020","description":"Chest x-ray 2vw frontal&latl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7567","description":"HCPCS-C7567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar wedge ro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3400","description":"Shoe metatarsal bar wedge ro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2399","description":"Lens trifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF1","description":"ICD-KBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7551","description":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33933","description":"Prepare donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert nasal septal button","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30220","description":"Insert nasal septal button","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB1","description":"ICD-OLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF1","description":"ICD-OFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF0","description":"ICD-OAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control w/ inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0710","description":"Ctlso a-p-l control w/ inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2956","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2956","description":"CDT-D2956","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid sup/access/dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5267","description":"Hearing aid sup/access/dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication admin visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1502","description":"Medication admin visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26358","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection into spinal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62294","description":"Injection into spinal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated leukocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85048","description":"Automated leukocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dry pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0184","description":"Dry pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE0","description":"ICD-CGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE0","description":"ICD-BICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair elevating leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0990","description":"Wheelchair elevating leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF0","description":"ICD-BFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise cornea with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65770","description":"Revise cornea with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB1","description":"ICD-MAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF0","description":"ICD-KISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB234","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii multimetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85247","description":"Clot factor viii multimetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD0","description":"ICD-OETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gen use back cush wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2611","description":"Gen use back cush wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytarabine liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9098","description":"Cytarabine liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB1","description":"ICD-KCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE1","description":"ICD-GETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb thx presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8696","description":"Antithromb thx presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0981T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","description":"CPT-0981T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA0","description":"ICD-GHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB241","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA1","description":"ICD-CFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC1","description":"ICD-AIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF0","description":"ICD-NDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0046U","description":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC0","description":"ICD-KGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA1","description":"ICD-CHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE1","description":"ICD-CGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD1","description":"ICD-GGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD1","description":"ICD-MICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4344","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","description":"HCPCS-Q4344","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Select picture audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92583","description":"Select picture audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB0","description":"ICD-NEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE0","description":"ICD-GHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB21","description":"ICD-3EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF0","description":"ICD-BFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/con_stres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8928","description":"Tte w or w/o fol w/con_stres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD1","description":"ICD-KASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hib prp-omp vacc 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90647","description":"Hib prp-omp vacc 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical chemistry test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84999","description":"Clinical chemistry test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF1","description":"ICD-NDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pin ulnar styloid fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25651","description":"Pin ulnar styloid fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iv inj ra drug dx study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78808","description":"Iv inj ra drug dx study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrotestosterone (DHT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82642","description":"Dihydrotestosterone (DHT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74420","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27422","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE0","description":"ICD-KBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24076","description":"Ex arm/elbow tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exam synovial fluid crystals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89060","description":"Exam synovial fluid crystals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99475","description":"Ped crit care age 2-5 init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44603","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB0","description":"ICD-BBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62302","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42844","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD1","description":"ICD-KIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF0","description":"ICD-OHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF0","description":"ICD-NFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2171","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD1","description":"ICD-JIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC0","description":"ICD-OKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1244","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC0","description":"ICD-GAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB0","description":"ICD-BAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE0","description":"ICD-AFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11307","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99426","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE1","description":"ICD-IBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE1","description":"ICD-KGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB1","description":"ICD-IBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64795","description":"Biopsy of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA1","description":"ICD-NLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC0","description":"ICD-BAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1037T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1037T","description":"CPT-1037T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4210","description":"Gingivectomy/plasty per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF0","description":"ICD-KHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual adult wc w tiltinspac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1161","description":"Manual adult wc w tiltinspac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intervene hlth/behave indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96152","description":"Intervene hlth/behave indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC1","description":"ICD-PIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF0","description":"ICD-ABDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA1","description":"ICD-CBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cromolyn sodium comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7632","description":"Cromolyn sodium comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC1","description":"ICD-BGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA1","description":"ICD-FCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01962","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","description":"CPT-01962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-99470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","description":"CPT-99470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA1","description":"ICD-EAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5272","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66740","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9912","description":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD0","description":"ICD-GDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA0","description":"ICD-EBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6955","description":"Above elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA0","description":"ICD-EITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91320","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voriconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3465","description":"Injection_ voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc agent rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4016F","description":"Anti-inflm/anlgsc agent rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC0","description":"ICD-CIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75557","description":"Cardiac MRI for morph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB0","description":"ICD-NCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF0","description":"ICD-HGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6570","description":"Gradient compression garment_ genital region_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA0","description":"ICD-OGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF1","description":"ICD-IAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD125","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF0","description":"ICD-GHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF1","description":"ICD-CFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC0","description":"ICD-GFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD0","description":"ICD-MGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF0","description":"ICD-IDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear medicine therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79999","description":"Nuclear medicine therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen supplies stand/rack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1355","description":"Oxygen supplies stand/rack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44380","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA0","description":"ICD-KDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spermicide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4269","description":"Spermicide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1828","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","description":"HCPCS-E1828","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt hx act drain prev 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8560","description":"Pt hx act drain prev 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD0","description":"ICD-ABBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB1","description":"ICD-OLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF0","description":"ICD-NEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insemination of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89268","description":"Insemination of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346T","description":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA121","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB1","description":"ICD-JAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA0","description":"ICD-BIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD1","description":"ICD-ECDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2617","description":"Stent_ non-cor_ tem w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD1","description":"ICD-DISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB1","description":"ICD-NFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96154","description":"Interv hlth/behav fam w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE1","description":"ICD-NJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF1","description":"ICD-CCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF1","description":"ICD-GDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD1","description":"ICD-GFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD1","description":"ICD-CHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA0","description":"ICD-FEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD0","description":"ICD-NGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0646U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0646U","description":"CPT-0646U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA1","description":"ICD-KCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED1","description":"ICD-JDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB1","description":"ICD-GAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0550U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0550U","description":"CPT-0550U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture aerobic identify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87077","description":"Culture aerobic identify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB0","description":"ICD-MCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autochondrocyte implant knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27412","description":"Autochondrocyte implant knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA1","description":"ICD-BHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA0","description":"ICD-NBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND0","description":"ICD-FGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11310","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE1","description":"ICD-JBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA0","description":"ICD-GBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE1","description":"ICD-MFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD0","description":"ICD-KBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA1","description":"ICD-CCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0182","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC1","description":"ICD-CHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF0","description":"ICD-IATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE1","description":"ICD-OGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tkr intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9234","description":"Tkr intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nervous system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64999","description":"Nervous system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/o leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1171","description":"Wheelchair amputee w/o leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF0","description":"ICD-CAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE121","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE1","description":"ICD-OAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/o dye w/ca test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75571","description":"Ct hrt w/o dye w/ca test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1006T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","description":"CPT-1006T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC1","description":"ICD-PGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c component-accessory nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0108","description":"W/c component-accessory nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF1","description":"ICD-KGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB0","description":"ICD-KFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA0","description":"ICD-PLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB1","description":"ICD-NEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295T","description":"Ext ecg complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE151","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL10","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5450","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA0","description":"ICD-DARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient alive as of the last day of the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9787","description":"Patient alive as of the last day of the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB23","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID0","description":"ICD-GBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3212","description":"Benesch boot pair infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC1","description":"ICD-GHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA0","description":"ICD-KHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID1","description":"ICD-NKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB44","description":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA0","description":"ICD-JCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB0","description":"ICD-FIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbtl implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21390","description":"Opn tx orbit periorbtl implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8E","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF0","description":"ICD-KHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD1","description":"ICD-FEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96159","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF0","description":"ICD-JBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth special head surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21851","description":"Anesth special head surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD0","description":"ICD-PJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB1","description":"ICD-AGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA0","description":"ICD-GHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF1","description":"ICD-CFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE1","description":"ICD-HEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trifoc prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0508","description":"Trifoc prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9072","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87542","description":"Legion pneumo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9592","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1474","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","description":"HCPCS-M1474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gross exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0472","description":"Gross exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB0","description":"ICD-PBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC0","description":"ICD-NEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD1","description":"ICD-PHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4D","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB0","description":"ICD-LESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay triiodothyronine (t3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84480","description":"Assay triiodothyronine (t3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodic orthodontc tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8670","description":"Periodic orthodontc tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF0","description":"ICD-FFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD0","description":"ICD-HAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD1","description":"ICD-KCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice continuous home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2043","description":"Hospice continuous home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF0","description":"ICD-EDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55840","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2C","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF0","description":"ICD-OEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC1","description":"ICD-KIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ froz/degly/wash","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9054","description":"Blood_ l/r_ froz/degly/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE1","description":"ICD-KCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1027","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB31","description":"ICD-2LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9026","description":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth low intestine scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81051","description":"Anesth low intestine scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA1","description":"ICD-FBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25420","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Death did not occur after discharge from the hospital within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9817","description":"Death did not occur after discharge from the hospital within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC1","description":"ICD-BDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE0","description":"ICD-MCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1501","description":"HCPCS-C1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE1","description":"ICD-NLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0155U","description":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99157","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD0","description":"ICD-JCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD0","description":"ICD-JAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC1","description":"ICD-LGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA0","description":"ICD-HDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB1","description":"ICD-FDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE0","description":"ICD-LHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE0","description":"ICD-FCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC0","description":"ICD-FBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45333","description":"Sigmoidoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED1","description":"ICD-MLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE0","description":"ICD-NEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group audiometric testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92559","description":"Group audiometric testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF1","description":"ICD-PHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation cone locator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5985","description":"Radiation cone locator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB0","description":"ICD-OFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB0","description":"ICD-AGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB0","description":"ICD-OGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD0","description":"ICD-BGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA201","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE0","description":"ICD-OJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA1","description":"ICD-JBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE0","description":"ICD-OBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles single system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92354","description":"Fit spectacles single system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE1","description":"ICD-CIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF1","description":"ICD-GEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prostaglandin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84150","description":"Assay of prostaglandin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0630T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC0","description":"ICD-PDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years And Older With A Diagnosis Of Frailty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2131","description":"Patients 81 Years And Older With A Diagnosis Of Frailty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2993","description":"Reteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets leukoreduced irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9033","description":"Platelets leukoreduced irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB206","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47538","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF0","description":"ICD-BCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72193","description":"Ct pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE1","description":"ICD-IEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt alive 3 mos post proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9540","description":"Pt alive 3 mos post proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF1","description":"ICD-KFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE1","description":"ICD-NGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","description":"HCPCS-M1415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC1","description":"ICD-FCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB06","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF0","description":"ICD-OLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47505","description":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29200","description":"Strapping of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50972","description":"Ureter endoscopy & catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB1","description":"ICD-OEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA1","description":"ICD-BAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF0","description":"ICD-OCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF1","description":"ICD-KIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC1","description":"ICD-CIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA0","description":"ICD-FBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE0","description":"ICD-GILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB55","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF1","description":"ICD-PAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54205","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA0","description":"ICD-FCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1557","description":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement bulb th lightbox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4634","description":"Replacement bulb th lightbox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0A","description":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF0","description":"ICD-BBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF0","description":"ICD-OGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB0","description":"ICD-NJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD0","description":"ICD-ICAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Out-of-hosp on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99027","description":"Out-of-hosp on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD0","description":"ICD-OFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65101","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA1","description":"ICD-CDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF0","description":"ICD-GBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6575","description":"Gradient compression arm sleeve and glove combination_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE0","description":"ICD-OIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko w/adj jt rot cntrl molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1844","description":"Ko w/adj jt rot cntrl molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryo embryo transf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4037","description":"Cryo embryo transf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7290","description":"Repositioning of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC116","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","description":"HCPCS-J1299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE0","description":"ICD-KCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE0","description":"ICD-GGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD0","description":"ICD-LCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB0","description":"ICD-NGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF0","description":"ICD-AATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE1","description":"ICD-CHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB1","description":"ICD-OKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD0","description":"ICD-NGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC1","description":"ICD-IAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD1","description":"ICD-OBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon metas evid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9087","description":"Onc dx colon metas evid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB1","description":"ICD-OGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF0","description":"ICD-IHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumoc vac/admin/rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4040F","description":"Pneumoc vac/admin/rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In morphine preservativ free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2274","description":"In morphine preservativ free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE1","description":"ICD-OEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE0","description":"ICD-AFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE0","description":"ICD-HIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94760","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB1","description":"ICD-FHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE1","description":"ICD-GEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67250","description":"Reinforce eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11640","description":"Exc f/e/e/n/l mal+mrg 0.5cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382U","description":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA1","description":"ICD-CAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC1","description":"ICD-JFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE1","description":"ICD-CFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC0","description":"ICD-HAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1461","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","description":"HCPCS-M1461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF0","description":"ICD-PDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Approp anticonvuls tstng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4191F","description":"Approp anticonvuls tstng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA1","description":"ICD-FIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD226","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA1","description":"ICD-MFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer system >300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1036","description":"Patient transfer system >300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC0","description":"ICD-CEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE1","description":"ICD-GDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7296","description":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB0","description":"ICD-EIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5106","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE1","description":"ICD-MCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01480","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","description":"CPT-01480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA1","description":"ICD-HEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rv5 vacc 3 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90680","description":"Rv5 vacc 3 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA1","description":"ICD-BFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB0","description":"ICD-MLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF1","description":"ICD-CHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD1","description":"ICD-IILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA1","description":"ICD-OIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-META0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META0","description":"ICD-META0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF1","description":"ICD-KBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB1","description":"ICD-NKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj hormone diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9560","description":"Ht inj hormone diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8521","description":"Capecitabine_ oral_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC12","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA1","description":"ICD-NAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC1","description":"ICD-GBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ingest challenge ini 120 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95076","description":"Ingest challenge ini 120 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE0","description":"ICD-OEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX01","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD0","description":"ICD-JHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC0","description":"ICD-FCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF0","description":"ICD-NEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF1","description":"ICD-JIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB51","description":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF1","description":"ICD-GGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB1","description":"ICD-JEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red cell survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78135","description":"Red cell survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC1","description":"ICD-ODBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF0","description":"ICD-OKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB0","description":"ICD-LGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA0","description":"ICD-HHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated rbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85041","description":"Automated rbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB1","description":"ICD-OJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA0","description":"ICD-OJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD0","description":"ICD-BAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB0","description":"ICD-ODTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot plas heel stabi pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3170","description":"Foot plas heel stabi pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scleral cover shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2627","description":"Scleral cover shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9294","description":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017U","description":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC33","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA0","description":"ICD-KAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA1","description":"ICD-CHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB0","description":"ICD-JGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82671","description":"Assay of estrogens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE0","description":"ICD-CGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF1","description":"ICD-NFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF1","description":"ICD-KCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0021","description":"Alcohol and/or drug training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC1","description":"ICD-KGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC0","description":"ICD-NHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47350","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9275","description":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36450","description":"Bl exchange/transfuse nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD1","description":"ICD-CGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD1","description":"ICD-HIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56640","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF0","description":"ICD-CGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iron sucrose injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1756","description":"Iron sucrose injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC1","description":"ICD-KGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0878","description":"Pwc gp4 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF1","description":"ICD-JGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE0","description":"ICD-IFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27327","description":"Exc thigh/knee les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE0","description":"ICD-EBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF0","description":"ICD-KIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9756","description":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay iga/igd/igg/igm each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82784","description":"Assay iga/igd/igg/igm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC1","description":"ICD-JAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2187","description":"Patients with clinical indications for imaging of the head: head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD1","description":"ICD-HDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67820","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA1","description":"ICD-BFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE216","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00580","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","description":"CPT-00580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB11","description":"ICD-2JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7509","description":"Methylprednisolone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD1","description":"ICD-FEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft femur head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27170","description":"Repair/graft femur head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC0","description":"ICD-CIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE1","description":"ICD-OCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auricular electrostimulation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8930","description":"Auricular electrostimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC0","description":"ICD-GBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD0","description":"ICD-NDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID1","description":"ICD-MDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD120","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB0","description":"ICD-GGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA0","description":"ICD-PFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA1","description":"ICD-KFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC1","description":"ICD-OBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE1","description":"ICD-OLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA0","description":"ICD-MHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB0","description":"ICD-FEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF1","description":"ICD-GIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE1","description":"ICD-CDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0700","description":"Safety equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytp dx eval fna 1st ea site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88172","description":"Cytp dx eval fna 1st ea site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB0","description":"ICD-KFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol or peroxide per pint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4244","description":"Alcohol or peroxide per pint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE0","description":"ICD-LIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA1","description":"ICD-NDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","description":"HCPCS-J1552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE1","description":"ICD-EBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC0","description":"ICD-CBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC0","description":"ICD-NGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36563","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD1","description":"ICD-GADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","description":"HCPCS-J0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC1","description":"ICD-BGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revas w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37224","description":"Fem/popl revas w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE1","description":"ICD-OJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE1","description":"ICD-BEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF0","description":"ICD-BDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest wall repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47251","description":"Anesth chest wall repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE0","description":"ICD-JDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA1","description":"ICD-NKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB1","description":"ICD-CHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL17","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina tissue compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57111","description":"Remove vagina tissue compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3B","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD0","description":"ICD-NEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC144","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE1","description":"ICD-CBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC0","description":"ICD-CBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init nb em per day non-fac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99461","description":"Init nb em per day non-fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2164","description":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD1","description":"ICD-NJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF1","description":"ICD-HARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC1","description":"ICD-ODMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB0","description":"ICD-FDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fo pip dip jnt/sprng pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3925","description":"Fo pip dip jnt/sprng pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Note hring tst w/in 6 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3230F","description":"Note hring tst w/in 6 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC0","description":"ICD-NIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE1","description":"ICD-IGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/wedge resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32666","description":"Thoracoscopy w/wedge resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD1","description":"ICD-CGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA11","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA05","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85557","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA1","description":"ICD-NBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE1","description":"ICD-BCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB11","description":"ICD-4CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90380","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52500","description":"Revision of bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protein c concentrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2724","description":"Protein c concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Next Gen aco model>20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9870","description":"Next Gen aco model>20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE1","description":"ICD-CALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0682","description":"Non-pneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE1","description":"ICD-CHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA1","description":"ICD-JHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB1","description":"ICD-MBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21077","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD1","description":"ICD-EBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35142","description":"Repair artery rupture thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB1","description":"ICD-NALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF1","description":"ICD-OBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF0","description":"ICD-KGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cltx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27767","description":"Cltx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contour of face bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21029","description":"Contour of face bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB0","description":"ICD-BDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA1","description":"ICD-NIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES112","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","description":"HCPCS-J2291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF1","description":"ICD-MFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supply kit homemi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4222","description":"Parenteral supply kit homemi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62146","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB1","description":"ICD-OEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB1","description":"ICD-BFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper limb orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3999","description":"Upper limb orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx crisis ea addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90840","description":"Psytx crisis ea addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8C","description":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB0","description":"ICD-OEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD0","description":"ICD-OCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA1","description":"ICD-OGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB0","description":"ICD-BBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB1","description":"ICD-ODVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0764T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1311","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX50","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24800","description":"Fusion of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25565","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA1","description":"ICD-OANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emer rspns sys serv permonth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5161","description":"Emer rspns sys serv permonth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF1","description":"ICD-PDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD0","description":"ICD-LHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE104","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014M","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA0","description":"ICD-DCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF0","description":"ICD-BGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace cvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36580","description":"Replace cvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58322","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient safety and support of positive experiences with anesthesia mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0059","description":"Patient safety and support of positive experiences with anesthesia mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC0","description":"ICD-KISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX06","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0620T","description":"Endovascular Venous Arterialization_ Tibial Or Peroneal Vein_ With Transcatheter Placement Of Intravascular Stent Graft(S) And Closure By Any Method_ Including Percutaneous Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA1","description":"ICD-OLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of lower spine disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72295","description":"X-ray of lower spine disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND0","description":"ICD-OAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84590","description":"Assay of vitamin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA0","description":"ICD-GFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC146","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF0","description":"ICD-OLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31766","description":"Reconstruction of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC101","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unscheduled dressing change","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4920","description":"Unscheduled dressing change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traditional healing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0051","description":"Traditional healing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE1","description":"ICD-AEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA0","description":"ICD-NLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF0","description":"ICD-OBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45307","description":"Proctosigmoidoscopy fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8500","description":"Hiv meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cst noble mtl inlay >=3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6607","description":"Cst noble mtl inlay >=3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0003","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF1","description":"ICD-MFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD1","description":"ICD-KGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB1","description":"ICD-DFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert prost urethral stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53855","description":"Insert prost urethral stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD0","description":"ICD-CHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB0","description":"ICD-IBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"marsupialization of odontogenic cyst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7509","description":"marsupialization of odontogenic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD0","description":"ICD-BGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0767","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0767","description":"HCPCS-E0767","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0897T","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 bodytemp >=35.5cw/in 30min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4559F","description":"1 bodytemp >=35.5cw/in 30min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01937","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","description":"CPT-01937","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carboplatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9045","description":"Carboplatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1303","description":"HCPCS-B1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonfamily homecare train/15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5115","description":"Nonfamily homecare train/15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME0","description":"ICD-GHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2A","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE0","description":"ICD-JEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF1","description":"ICD-GDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd for bar w lk fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4420","description":"Ost pch clsd for bar w lk fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB0","description":"ICD-GCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF1","description":"ICD-CHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB0","description":"ICD-BBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE1","description":"ICD-OECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icatibant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1744","description":"Icatibant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF1","description":"ICD-KAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB1","description":"ICD-OLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11444","description":"Exc face-mm b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sys bp less 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8752","description":"Sys bp less 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA1","description":"ICD-BENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF1","description":"ICD-CINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC1","description":"ICD-PAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove external ear partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69110","description":"Remove external ear partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC1","description":"ICD-OJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE1","description":"ICD-IHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA0","description":"ICD-KGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD0","description":"ICD-AHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE1","description":"ICD-OHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB1","description":"ICD-NIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4131F","description":"Syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aed garment w elec analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0606","description":"Aed garment w elec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB1","description":"ICD-GFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC111","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF0","description":"ICD-GHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOCOCCUS NEOFORMANS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87327","description":"IAAD IA CRYPTOCOCCUS NEOFORMANS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE1","description":"ICD-OBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA1","description":"ICD-GANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atten current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9165","description":"Atten current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC0","description":"ICD-MHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC0","description":"ICD-JFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD0","description":"ICD-NLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro/pos cus<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2624","description":"Adj skin pro/pos cus<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1125","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hf measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8548","description":"Hf measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB1","description":"ICD-KCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE0","description":"ICD-GDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collect/review data from pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99091","description":"Collect/review data from pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97171","description":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID1","description":"ICD-BIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB1","description":"ICD-IFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC0","description":"ICD-MLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA1","description":"ICD-KIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zanamivir_inhalation pwd 10m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9018","description":"Zanamivir_inhalation pwd 10m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC1","description":"ICD-NDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45308","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB0","description":"ICD-NJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1255","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45005","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF0","description":"ICD-OHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC1","description":"ICD-KDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF1","description":"ICD-OFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF1","description":"ICD-FBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD0","description":"ICD-PFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF1","description":"ICD-BHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC0","description":"ICD-AFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC1","description":"ICD-IEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD1","description":"ICD-GBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF0","description":"ICD-EDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE0","description":"ICD-PDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB0","description":"ICD-NABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32507","description":"Wedge resect of lung diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE0","description":"ICD-IEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Finasteride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0138","description":"Finasteride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD1","description":"ICD-JDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29880","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD204","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Als 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0433","description":"Als 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE0","description":"ICD-EBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB0","description":"ICD-NGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB1","description":"ICD-MELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB0","description":"ICD-BGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC1","description":"ICD-FHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27508","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA0","description":"ICD-JFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD0","description":"ICD-GAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB0","description":"ICD-KHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE0","description":"ICD-OCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients With A Catheter That Have Limited Life Expectancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0050","description":"Patients With A Catheter That Have Limited Life Expectancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supported employ_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2023","description":"Supported employ_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9092","description":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens hydrophilic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2520","description":"Contact lens hydrophilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB1","description":"ICD-JDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC144","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB1","description":"ICD-NLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA0","description":"ICD-BHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9049","description":"Injection_ bortezomib (hospira)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee cap medial or lateral p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2800","description":"Knee cap medial or lateral p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33410","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iris Prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1839","description":"Iris Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA1","description":"ICD-JCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB0","description":"ICD-DFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC1","description":"ICD-NDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2791","description":"Crown full cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE1","description":"ICD-JFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-53865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","description":"CPT-53865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","description":"CPT-15012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF0","description":"ICD-GGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Memoderm/derma/tranz/integup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4126","description":"Memoderm/derma/tranz/integup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND1","description":"ICD-NAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28490","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8H","description":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD0","description":"ICD-EGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB1","description":"ICD-NEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing paternity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86910","description":"Blood typing paternity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE250","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Near ifr guide of vasc site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287T","description":"Near ifr guide of vasc site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64605","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE0","description":"ICD-NFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB0","description":"ICD-BHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate/fx repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31630","description":"Bronchoscopy dilate/fx repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22859","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28126","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52320","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA1","description":"ICD-NGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA0","description":"ICD-OJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB0","description":"ICD-BATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37269","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","description":"CPT-37269","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF1","description":"ICD-JCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF1","description":"ICD-CGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27220","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0027","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic donning sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7600","description":"Prosthetic donning sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart tmr w/other procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33141","description":"Heart tmr w/other procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD1","description":"ICD-KITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54240","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytal_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4166","description":"Cytal_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF0","description":"ICD-GECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE0","description":"ICD-BENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF0","description":"ICD-CCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD1","description":"ICD-KBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36120","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB0","description":"ICD-EDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34708","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing care_ in the home; b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9124","description":"Nursing care_ in the home; b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA0","description":"ICD-NDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8E","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD1","description":"ICD-NGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3919","description":"Ho w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_ non-prog_temp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2626","description":"Infusion pump_ non-prog_temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC1","description":"ICD-IATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vulva lesion/s compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56515","description":"Destroy vulva lesion/s compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE1","description":"ICD-KBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oximeter device for measuring bloodk osygen levels noninvasively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0445","description":"Oximeter device for measuring bloodk osygen levels noninvasively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd aspirin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4563F","description":"Pt recvd aspirin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB0","description":"ICD-FDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC1","description":"ICD-NLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF0","description":"ICD-KEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58210","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF1","description":"ICD-NDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC1","description":"ICD-ICUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0626U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","description":"CPT-0626U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0037","description":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9048","description":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9489","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ betibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3393","description":"Injection_ betibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25251","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehab/monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93798","description":"Cardiac rehab/monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD1","description":"ICD-GIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF0","description":"ICD-FHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8D","description":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF1","description":"ICD-HBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam sacrum tailbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72220","description":"X-ray exam sacrum tailbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0676U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676U","description":"CPT-0676U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC1","description":"ICD-BGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block cont infuse b plex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64416","description":"N block cont infuse b plex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA1","description":"ICD-KINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB1","description":"ICD-BDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD1","description":"ICD-EHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD1","description":"ICD-HHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0524T","description":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46257","description":"Remove in/ex hem grp & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96165","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB1","description":"ICD-KGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ intraocular (new tech)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1780","description":"Lens_ intraocular (new tech)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA1","description":"ICD-EHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD1","description":"ICD-AELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA1","description":"ICD-IFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB1","description":"ICD-NDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1471","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","description":"HCPCS-M1471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA0","description":"ICD-JAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF1","description":"ICD-KEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD0","description":"ICD-KCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC1","description":"ICD-GDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF1","description":"ICD-GGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory tst complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92588","description":"Evoked auditory tst complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna/rna hiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87906","description":"Genotype dna/rna hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87534","description":"Hiv-1 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Singlay_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4329","description":"Singlay_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD0","description":"ICD-IDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0319U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37271","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","description":"CPT-37271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA0","description":"ICD-MICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE1","description":"ICD-OLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection anistreplase 30 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0350","description":"Injection anistreplase 30 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99243","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC0","description":"ICD-KDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB0","description":"ICD-NIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64712","description":"Revision of sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF0","description":"ICD-JHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef>=40% doc normal or mild","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8395","description":"Lvef>=40% doc normal or mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62361","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC0","description":"ICD-KCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC1","description":"ICD-NLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB1","description":"ICD-NADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE0","description":"ICD-CAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95726","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB1","description":"ICD-ICEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient spent less than three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9860","description":"Patient spent less than three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35515","description":"Art byp grft subclav-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD0","description":"ICD-CAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE0","description":"ICD-NALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43762","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11762","description":"Reconstruction of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF1","description":"ICD-CFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC1","description":"ICD-OCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sialoendoscopy capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0371","description":"Sialoendoscopy capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD1","description":"ICD-EEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF0","description":"ICD-IIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01652","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","description":"CPT-01652","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5A","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE1","description":"ICD-KESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC0","description":"ICD-KFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC0","description":"ICD-GAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6113","description":"Imp/abut rem dent part mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15853","description":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25922","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC1","description":"ICD-OGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15934","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB1","description":"ICD-AGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD0","description":"ICD-GBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ com","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8921","description":"Tte w or w/o fol w/cont_ com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain nobel metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6242","description":"Bridge porcelain nobel metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mast mod rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19307","description":"Mast mod rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rehabilitation program 1/2 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2001","description":"Rehabilitation program 1/2 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap proctopexy w/sig resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45402","description":"Lap proctopexy w/sig resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC1","description":"ICD-FIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fosphenytoin inj pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2009","description":"Fosphenytoin inj pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9607","description":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic injection/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51715","description":"Endoscopic injection/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD0","description":"ICD-HEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD0","description":"ICD-LBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD1","description":"ICD-OEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB0","description":"ICD-JEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy for lvrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32672","description":"Thoracoscopy for lvrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us follow-up per fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76816","description":"Ob us follow-up per fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC0","description":"ICD-OFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB45","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD0","description":"ICD-BAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF0","description":"ICD-KAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB11","description":"ICD-1CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE1","description":"ICD-MJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA0","description":"ICD-CDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA0","description":"ICD-JDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB0","description":"ICD-DDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-83884","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","description":"CPT-83884","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33279","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC1","description":"ICD-AIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC0","description":"ICD-NDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF1","description":"ICD-DBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81106","description":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE0","description":"ICD-GBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE1","description":"ICD-AHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF0","description":"ICD-JCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB235","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE0","description":"ICD-OGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker folding wheeled w/o s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0143","description":"Walker folding wheeled w/o s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC0","description":"ICD-AHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC1","description":"ICD-FIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF1","description":"ICD-MDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF1","description":"ICD-NACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99306","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB0","description":"ICD-LHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD1","description":"ICD-EBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB0","description":"ICD-KILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC0","description":"ICD-FFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB1","description":"ICD-IDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD0","description":"ICD-FCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99226","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB0","description":"ICD-GFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29450","description":"Application of leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB0","description":"ICD-KDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF0","description":"ICD-PESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE1","description":"ICD-BIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ing hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49520","description":"Rerepair ing hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF0","description":"ICD-GAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1009T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","description":"CPT-1009T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB1","description":"ICD-AGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD1","description":"ICD-JBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27596","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF1","description":"ICD-BBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol carb > 50%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4180","description":"Parenteral sol carb > 50%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sex hormone globul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84270","description":"Assay of sex hormone globul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0226U","description":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33236","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF0","description":"ICD-NJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscop w/arytenoidectom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31560","description":"Laryngoscop w/arytenoidectom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD0","description":"ICD-OHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC1","description":"ICD-CIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 10-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88273","description":"Cytogenetics 10-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27510","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1008","description":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6018","description":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sphenoid sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31051","description":"Sphenoid sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD1","description":"ICD-FDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excisional biopsy of minor salivary glands","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7284","description":"Excisional biopsy of minor salivary glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise thigh muscles/tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27400","description":"Revise thigh muscles/tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE1","description":"ICD-KGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9808","description":"HCPCS-C9808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6073","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiolipin antibody ea ig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86147","description":"Cardiolipin antibody ea ig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01969","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","description":"CPT-01969","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1352","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA0","description":"ICD-OBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE1","description":"ICD-MLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy splenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38120","description":"Laparoscopy splenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA0","description":"ICD-CAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB1","description":"ICD-KHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD1","description":"ICD-ODFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF0","description":"ICD-ODBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo ankle gauntlet pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1902","description":"Afo ankle gauntlet pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35511","description":"Art byp grft subclav-subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC1","description":"ICD-NCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suture large intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44604","description":"Suture large intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB0","description":"ICD-KAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41850","description":"Treatment of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8D","description":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair anorectal fist w/plug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46707","description":"Repair anorectal fist w/plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plast socket jts/thgh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5105","description":"Plast socket jts/thgh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA0","description":"ICD-AIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of dibucaine number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82638","description":"Assay of dibucaine number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC1","description":"ICD-BEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40816","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA1","description":"ICD-AIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD1","description":"ICD-KALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD0","description":"ICD-DIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscop rotator cuff repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29827","description":"Arthroscop rotator cuff repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB0","description":"ICD-OHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB0","description":"ICD-BHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no hist type rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9288","description":"Doc medrsn no hist type rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB0","description":"ICD-DIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44364","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colistimethate inh sol mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0142","description":"Colistimethate inh sol mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0824","description":"Pwc gp 2 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB0","description":"ICD-KHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE0","description":"ICD-JCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Central dexa results docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3095F","description":"Central dexa results docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC0","description":"ICD-NAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD1","description":"ICD-CHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of peritoneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74190","description":"X-ray exam of peritoneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF1","description":"ICD-KAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7521","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF1","description":"ICD-NEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63005","description":"Remove spine lamina 1/2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB0","description":"ICD-NJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA1","description":"ICD-BAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15937","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD1","description":"ICD-KFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB0","description":"ICD-OJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE1","description":"ICD-BIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD1","description":"ICD-JDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB0","description":"ICD-EIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27759","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Becaplermin gel 1%_ 0.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0157","description":"Becaplermin gel 1%_ 0.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE0","description":"ICD-DASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD1","description":"ICD-JIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC1","description":"ICD-OFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE0","description":"ICD-OHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC0","description":"ICD-KCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9711","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC0","description":"ICD-MCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB0","description":"ICD-NHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL53","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD0","description":"ICD-CABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1401","description":"HCPCS-A1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64834","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE1","description":"ICD-IHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0104","description":"HCPCS-A0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA1","description":"ICD-KGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC1","description":"ICD-OFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF1","description":"ICD-HGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB0","description":"ICD-OFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38228","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","description":"CPT-38228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE0","description":"ICD-EFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0549T","description":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB0","description":"ICD-NKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC26","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE1","description":"ICD-BCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC1","description":"ICD-MBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86408","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC1","description":"ICD-GBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45563","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD0","description":"ICD-OKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0505","description":"HCPCS-A0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE1","description":"ICD-HAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA0","description":"ICD-CFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE0","description":"ICD-CDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98001","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","description":"CPT-98001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mild osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8848","description":"Mild osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quant oxcarbazepin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80183","description":"Drug scrn quant oxcarbazepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcochlear approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61596","description":"Transcochlear approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC1","description":"ICD-KAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mdd severe w/o psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3090F","description":"Mdd severe w/o psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36473","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; first target lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76982","description":"Ultrasound_ elastography; first target lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admin + supply_ tositumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3001","description":"Admin + supply_ tositumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subs episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1128F","description":"Subs episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD1","description":"ICD-LBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD0","description":"ICD-GILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA0","description":"ICD-JAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB0","description":"ICD-KIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC0","description":"ICD-PIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC1","description":"ICD-OJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l4/l5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309T","description":"Prescrl fuse w/ instr l4/l5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA0","description":"ICD-GCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE1","description":"ICD-FCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE1","description":"ICD-IIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholinesterase assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82013","description":"Acetylcholinesterase assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1330","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1330","description":"HCPCS-L1330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB0","description":"ICD-MHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD0","description":"ICD-OGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF0","description":"ICD-MALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA0","description":"ICD-CBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF0","description":"ICD-OEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA0","description":"ICD-KDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonneedle injection device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4210","description":"Nonneedle injection device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo pos solid ank plastic mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1960","description":"Afo pos solid ank plastic mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0803","description":"HCPCS-A0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m medronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9503","description":"Tc99m medronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB0","description":"ICD-GFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2626","description":"Reduction of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC0","description":"ICD-OITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rilonacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2793","description":"Rilonacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB0","description":"ICD-EBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF1","description":"ICD-BFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF0","description":"ICD-OIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA1","description":"ICD-CDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE0","description":"ICD-NKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE0","description":"ICD-ICDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC0","description":"ICD-MFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26502","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA0","description":"ICD-CDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF1","description":"ICD-IFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76965","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB40","description":"Low Rehab_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD0","description":"ICD-CBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC0","description":"ICD-IGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF0","description":"ICD-CIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA1","description":"ICD-GFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC1","description":"ICD-ABBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain thyroid/tongue cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60000","description":"Drain thyroid/tongue cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood methemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83050","description":"Blood methemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE1","description":"ICD-NDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE1","description":"ICD-IELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA1","description":"ICD-NJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ liq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0442","description":"Stationary o2 contents_ liq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE0","description":"ICD-BFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD1","description":"ICD-FGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC1","description":"ICD-GIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD0","description":"ICD-FGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0480","description":"Cytopath smear prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC1","description":"ICD-IAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF1","description":"ICD-JIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54328","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Morphine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2270","description":"Morphine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE0","description":"ICD-CEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA0","description":"ICD-BHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6019","description":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6895","description":"Custom glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB1","description":"ICD-OHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA0","description":"ICD-JGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC0","description":"ICD-KIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF1","description":"ICD-KGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA1","description":"ICD-CDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF1","description":"ICD-CGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair laminectomy defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63295","description":"Repair laminectomy defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44121","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD0","description":"ICD-GDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mental health service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0046","description":"Mental health service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB0","description":"ICD-CBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer ultrasonic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0575","description":"Nebulizer ultrasonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB14","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC1","description":"ICD-PFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD0","description":"ICD-DAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use txmnt counseling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4000F","description":"Tobacco use txmnt counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE0","description":"ICD-CFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE0","description":"ICD-BBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy excise lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58662","description":"Laparoscopy excise lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF0","description":"ICD-AIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69433","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF0","description":"ICD-EDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB0","description":"ICD-GHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC0","description":"ICD-AIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA1","description":"ICD-OJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA11","description":"ICD-2EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB221","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA1","description":"ICD-DHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF0","description":"ICD-LBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metacarpophalangeal implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8630","description":"Metacarpophalangeal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC1","description":"ICD-GCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81171","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID1","description":"ICD-MEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0026","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt simple w/comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77522","description":"Proton trmt simple w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87807","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC1","description":"ICD-JGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75705","description":"Artery x-rays spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75825","description":"Vein x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE1","description":"ICD-OKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93227","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF0","description":"ICD-EGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81381","description":"Hla i typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct simpl maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7620","description":"Clsd reduct simpl maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pedicle e/n/e/l/ntroral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15576","description":"Pedicle e/n/e/l/ntroral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF1","description":"ICD-JCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2799","description":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD1","description":"ICD-MGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23182","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC1","description":"ICD-PKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral administration ki","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4224","description":"Parenteral administration ki","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CoreCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4240","description":"CoreCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB31","description":"ICD-1LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA1","description":"ICD-KHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB0","description":"ICD-GEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB0","description":"ICD-NAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC1","description":"ICD-KFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC11","description":"ICD-2GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splint wrist or ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8451","description":"Splint wrist or ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD1","description":"ICD-MDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC1","description":"ICD-PGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Integra matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4108","description":"Integra matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE0","description":"ICD-EFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair spigelian hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49590","description":"Repair spigelian hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l addl 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13122","description":"Cmplx rpr s/a/l addl 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC0","description":"ICD-GBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50574","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vancomycin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3370","description":"Vancomycin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD0","description":"ICD-AEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB1","description":"ICD-MIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE0","description":"ICD-OALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial brush biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31717","description":"Bronchial brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB226","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA1","description":"ICD-NJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC1","description":"ICD-MDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1099T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1099T","description":"CPT-1099T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB0","description":"ICD-GCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27600","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB1","description":"ICD-KIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2753","description":"Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE1","description":"ICD-NAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC1","description":"ICD-PIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA1","description":"ICD-OBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59150","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME0","description":"ICD-GFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD0","description":"ICD-JDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern block > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49587","description":"Rpr umbil hern block > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4337","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","description":"HCPCS-Q4337","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0819T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low back disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63030","description":"Low back disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD1","description":"ICD-LCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA0","description":"ICD-OHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC0","description":"ICD-ODMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD0","description":"ICD-OHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE1","description":"ICD-FDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28546","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD0","description":"ICD-AILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE0","description":"ICD-ODEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE1","description":"ICD-FCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect hand tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26117","description":"Rad resect hand tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL16","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE1","description":"ICD-BHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","description":"CPT-00842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF1","description":"ICD-OAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB0","description":"ICD-NCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD1","description":"ICD-KCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD1","description":"ICD-EHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF1","description":"ICD-KCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA0","description":"ICD-NIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE1","description":"ICD-OHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0047","description":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA1","description":"ICD-IBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC1","description":"ICD-NKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF0","description":"ICD-ABMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF1","description":"ICD-DFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC1","description":"ICD-BDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC0","description":"ICD-CCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC31","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj levocarnitine per 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1955","description":"Inj levocarnitine per 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB0","description":"ICD-OAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump refill kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4220","description":"Infusion pump refill kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE1","description":"ICD-AGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF1","description":"ICD-BFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE0","description":"ICD-JIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81286","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0826","description":"Pwc gp 2 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE0","description":"ICD-NCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC1","description":"ICD-FAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abduction bar-straight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2310","description":"Abduction bar-straight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD0","description":"ICD-OHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation handling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77790","description":"Radiation handling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01716","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","description":"CPT-01716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD0","description":"ICD-CERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54336","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB1","description":"ICD-HBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA115","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA1","description":"ICD-OEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-specific kinase (MuSK) antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86366","description":"Muscle-specific kinase (MuSK) antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Belt/vest elec/combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0499","description":"Belt/vest elec/combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE1","description":"ICD-OJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB0","description":"ICD-GALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED0","description":"ICD-GDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human fibrinogen conc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7178","description":"Human fibrinogen conc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytp urine 3-5 probes cmptr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88121","description":"Cytp urine 3-5 probes cmptr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC0","description":"ICD-GGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB1","description":"ICD-BIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF0","description":"ICD-OJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special supplies phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99070","description":"Special supplies phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD1","description":"ICD-KHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Erwinaze injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9019","description":"Erwinaze injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE0","description":"ICD-AEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE0","description":"ICD-KIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag and followup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9548","description":"Abd imag and followup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5A","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF0","description":"ICD-NKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80377","description":"Drug/substance nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB230","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB1","description":"ICD-FBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5153","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","description":"HCPCS-Q5153","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB1","description":"ICD-OGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flutter device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8185","description":"Flutter device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF1","description":"ICD-AHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD1","description":"ICD-FCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC0","description":"ICD-KBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86308","description":"Heterophile antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0674T","description":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86971","description":"Rbc pretx incubatj w/enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB1","description":"ICD-CCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD1","description":"ICD-KDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF0","description":"ICD-BBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas ext receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1037","description":"Art pancreas ext receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt nf per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94004","description":"Vent mgmt nf per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108U","description":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF0","description":"ICD-EFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD0","description":"ICD-NICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd biopsy single/multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43239","description":"Egd biopsy single/multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47630","description":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD1","description":"ICD-AHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA1","description":"ICD-KGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c probe&rvrs trnsc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87521","description":"Hepatitis c probe&rvrs trnsc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD0","description":"ICD-OKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC1","description":"ICD-MJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis st louis antbody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86653","description":"Encephaltis st louis antbody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pooling blood platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86965","description":"Pooling blood platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD0","description":"ICD-KCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD1","description":"ICD-GFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE1","description":"ICD-NJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF1","description":"ICD-PISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC0","description":"ICD-KERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF1","description":"ICD-EGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0322U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA0","description":"ICD-KCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF1","description":"ICD-GANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73702","description":"Ct lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE0","description":"ICD-PERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81521","description":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC01","description":"Very High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA0","description":"ICD-KAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB0","description":"ICD-KFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haptoglobin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83010","description":"Assay of haptoglobin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME1","description":"ICD-MAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE0","description":"ICD-PEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7939","description":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/debride pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48105","description":"Resect/debride pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF0","description":"ICD-ABHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD0","description":"ICD-NDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4540","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnanediol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84135","description":"Assay of pregnanediol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2041","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE1","description":"ICD-LEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheterize for urine spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9612","description":"Catheterize for urine spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF0","description":"ICD-JAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF0","description":"ICD-AGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33234","description":"Removal of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC0","description":"ICD-MHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD0","description":"ICD-GCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE1","description":"ICD-NKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB1","description":"ICD-EAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86710","description":"Influenza virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA0","description":"ICD-MKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC1","description":"ICD-EDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID1","description":"ICD-EBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD0","description":"ICD-CCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried pain fxn w/ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1502F","description":"Pt queried pain fxn w/ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA1","description":"ICD-BFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB1","description":"ICD-BFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC1","description":"ICD-CEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB21","description":"ICD-4DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0402","description":"HCPCS-C0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE1","description":"ICD-KGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB1","description":"ICD-GIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE0","description":"ICD-CFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE0","description":"ICD-GDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69200","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF0","description":"ICD-DBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA0","description":"ICD-GFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB0","description":"ICD-FDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric symptoms not assessed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9743","description":"Psychiatric symptoms not assessed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"T cell absolute count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86361","description":"T cell absolute count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88007","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF1","description":"ICD-NKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20694","description":"Remove bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC0","description":"ICD-CGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Create tear sac drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68720","description":"Create tear sac drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee total contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5637","description":"Below knee total contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP RHD1-10&RHCE5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198U","description":"RHD&RHCE GNTYP RHD1-10&RHCE5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of nasal adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30560","description":"Release of nasal adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE0","description":"ICD-JIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA1","description":"ICD-JFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA1","description":"ICD-JDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC0","description":"ICD-GDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE1","description":"ICD-BDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD0","description":"ICD-OAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB1","description":"ICD-NINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF0","description":"ICD-FDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC1","description":"ICD-BDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE1","description":"ICD-LDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB0","description":"ICD-JCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of arm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23931","description":"Drainage of arm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo remove w/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50548","description":"Laparo remove w/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4522","description":"Adult size brief/diaper med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB1","description":"ICD-OALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC0","description":"ICD-JGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","description":"HCPCS-Q4409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla open reduct simple","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7610","description":"Maxilla open reduct simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reusable rectal thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4932","description":"Reusable rectal thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF1","description":"ICD-NHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0076","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE1","description":"ICD-DFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35092","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gen use back cush wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2612","description":"Gen use back cush wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA16","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD0","description":"ICD-MJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA0","description":"ICD-KEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB1","description":"ICD-IGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE1","description":"ICD-MALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC0","description":"ICD-ODEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC1","description":"ICD-BHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF0","description":"ICD-NANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE1","description":"ICD-FAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pres/absn hmrhg/lesion docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3110F","description":"Pres/absn hmrhg/lesion docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB0","description":"ICD-DESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC146","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87581","description":"M.pneumon dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2C","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC0","description":"ICD-HGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Folding ped wc tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1232","description":"Folding ped wc tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC0","description":"ICD-JFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9191","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9191","description":"HCPCS-J9191","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA0","description":"ICD-BHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesiolysis tube ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58740","description":"Adhesiolysis tube ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enema tube_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1013","description":"Enema tube_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","description":"CPT-00212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"New eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92018","description":"New eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD1","description":"ICD-BHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment plan development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1007","description":"Treatment plan development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wc planar back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2620","description":"Wc planar back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE1","description":"ICD-AFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF1","description":"ICD-PARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal bk ultralt mater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5785","description":"Exoskeletal bk ultralt mater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive preoperative assessment performed for cataract surgery with i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0122U","description":"Comprehensive preoperative assessment performed for cataract surgery with i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB1","description":"ICD-FEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"H&p for surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0260","description":"H&p for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE1","description":"ICD-NILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA1","description":"ICD-NFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA1","description":"ICD-NFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cptr ophth dx img post segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92134","description":"Cptr ophth dx img post segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1302","description":"Injection_ sutimlimab-jome_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC0","description":"ICD-KGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA1","description":"ICD-BDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA0","description":"ICD-OGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289U","description":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB1","description":"ICD-JCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD1","description":"ICD-KHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av fuse uppr arm cephalic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36818","description":"Av fuse uppr arm cephalic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC0","description":"ICD-GEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9687","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE1","description":"ICD-KHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA0","description":"ICD-CFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF0","description":"ICD-BEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","description":"HCPCS-J1612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91319","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24320","description":"Repair of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22870","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; second","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4336","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","description":"HCPCS-Q4336","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90646","description":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flu vac pandem prsrv free im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90666","description":"Flu vac pandem prsrv free im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF1","description":"ICD-CAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD1","description":"ICD-KBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1318","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA1","description":"ICD-NGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8C","description":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us detailed sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76811","description":"Ob us detailed sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht hemodialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9335","description":"Ht hemodialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable insert each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6691","description":"Removable insert each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE1","description":"ICD-FIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA0","description":"ICD-GFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB0","description":"ICD-MBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of toe joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28272","description":"Release of toe joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD0","description":"ICD-JFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of total thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84436","description":"Assay of total thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Truss single w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8300","description":"Truss single w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ brst_ un","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8905","description":"MRI w/o fol w/cont_ brst_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32853","description":"Lung transplant double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC126","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE1","description":"ICD-PFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9314","description":"Injection_ pemetrexed (Teva) not therapeutically equivalent to J9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33476","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA0","description":"ICD-ODWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin fluid swg & stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5728","description":"Knee-shin fluid swg & stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA0","description":"ICD-NLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF1","description":"ICD-BFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD0","description":"ICD-CDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derma-fat-fascia graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15770","description":"Derma-fat-fascia graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA0","description":"ICD-EDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1286","description":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE1","description":"ICD-KCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77263","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68530","description":"Clearance of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE1","description":"ICD-GGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00406","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","description":"CPT-00406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF1","description":"ICD-KBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"(Blincyto)Injection_ Blinatumomab_ 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9449","description":"(Blincyto)Injection_ Blinatumomab_ 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED1","description":"ICD-MGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA0","description":"ICD-FDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term device_ multi art digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6715","description":"Term device_ multi art digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA1","description":"ICD-OELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow disarticulation switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6940","description":"Elbow disarticulation switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Voice amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8510","description":"Voice amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bekesy audiometry diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92561","description":"Bekesy audiometry diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx complx malar fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21365","description":"Opn tx complx malar fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26560","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69209","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE0","description":"ICD-PGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF1","description":"ICD-IEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC1","description":"ICD-PIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16074","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16074","description":"CPT-16074","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9256","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","description":"HCPCS-J9256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92002","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB0","description":"ICD-CBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB0","description":"ICD-AHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3401","description":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8A","description":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF0","description":"ICD-FCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62559","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1328","description":"Patients with a diagnosis of acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB1","description":"ICD-CHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0680T","description":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78607","description":"Brain imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0885T","description":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE1","description":"ICD-IDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27889","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC0","description":"ICD-HHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES220","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place needles pelvic for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55920","description":"Place needles pelvic for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA1","description":"ICD-CCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC1","description":"ICD-NGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ diclofenac sodium_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1130","description":"Injection_ diclofenac sodium_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE260","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1014","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE1","description":"ICD-NFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0590T","description":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0910T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","description":"CPT-0910T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA0","description":"ICD-JBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press adhere no perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8855","description":"Pos air press adhere no perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF0","description":"ICD-GHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8H","description":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA0","description":"ICD-NKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB1","description":"ICD-FFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Q fever antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86638","description":"Q fever antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33413","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric symptoms assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9742","description":"Psychiatric symptoms assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD1","description":"ICD-FBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0160U","description":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD0","description":"ICD-PHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87390","description":"IAAD IA HIV-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB01","description":"Medium Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE1","description":"ICD-NDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF0","description":"ICD-CDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21246","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB0","description":"ICD-GAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0027U","description":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD1","description":"ICD-OLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam infant hips static","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76886","description":"Us exam infant hips static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC1","description":"ICD-JDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC0","description":"ICD-CCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE1","description":"ICD-FFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB0","description":"ICD-GFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD1","description":"ICD-GDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF1","description":"ICD-JHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69620","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE0","description":"ICD-IECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA0","description":"ICD-OCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC1","description":"ICD-PJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE1","description":"ICD-PLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF1","description":"ICD-GHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME0","description":"ICD-OJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA1","description":"ICD-BGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA0","description":"ICD-JFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA1","description":"ICD-JETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA15","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB0","description":"ICD-FAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fragmenting of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50590","description":"Fragmenting of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Simple cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51725","description":"Simple cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA0","description":"ICD-NCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB0","description":"ICD-BCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Truss double w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8310","description":"Truss double w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB1","description":"ICD-AFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0991T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","description":"CPT-0991T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF0","description":"ICD-OFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3318F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC1","description":"ICD-CIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA1","description":"ICD-GCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE1","description":"ICD-KFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder flexion-abduction j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6645","description":"Shoulder flexion-abduction j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total hip resurfacing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2118","description":"Total hip resurfacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31580","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB0","description":"ICD-AFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF0","description":"ICD-GAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA0","description":"ICD-KHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC1","description":"ICD-CGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE0","description":"ICD-BFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD1","description":"ICD-HBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27828","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9079","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD0","description":"ICD-OBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE1","description":"ICD-JALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1473","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","description":"HCPCS-M1473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC0","description":"ICD-OAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE0","description":"ICD-OCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE1","description":"ICD-OCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE0","description":"ICD-GCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB1","description":"ICD-KADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE0","description":"ICD-LAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3351","description":"Apexification/recalc initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doxorubicin inj 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2050","description":"Doxorubicin inj 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB1","description":"ICD-GERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB1","description":"ICD-OBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA1","description":"ICD-MCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral grav diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9341","description":"Hit enteral grav diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC0","description":"ICD-CEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue to lip surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41510","description":"Tongue to lip surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB0","description":"ICD-NGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA1","description":"ICD-NKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63662","description":"Remove spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE141","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55810","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9464","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC0","description":"ICD-NFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quadrilateral brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2188","description":"Quadrilateral brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD1","description":"ICD-OELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB0","description":"ICD-OCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF0","description":"ICD-EHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93622","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA0","description":"ICD-KBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF1","description":"ICD-OFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC1","description":"ICD-OGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA1","description":"ICD-CGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9602","description":"Perc d-e cor stent ather s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75842","description":"Vein x-ray adrenal glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE0","description":"ICD-MDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD0","description":"ICD-HIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC0","description":"ICD-OKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD0","description":"ICD-NFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA1","description":"ICD-CASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC1","description":"ICD-MHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1492","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","description":"HCPCS-M1492","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME1","description":"ICD-NBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD0","description":"ICD-OBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB0","description":"ICD-KBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46746","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC1","description":"ICD-CHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 3vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72072","description":"X-ray exam thorac spine 3vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0980T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","description":"CPT-0980T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4481","description":"Tracheostoma filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE0","description":"ICD-FICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0669","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0669","description":"HCPCS-G0669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA1","description":"ICD-JAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic surface emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96002","description":"Dynamic surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD0","description":"ICD-LHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC1","description":"ICD-KHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME1","description":"ICD-MBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC0","description":"ICD-EDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB1","description":"ICD-CFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Approp ace/arb tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4188F","description":"Approp ace/arb tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME0","description":"ICD-NGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","description":"HCPCS-Q4433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED1","description":"ICD-FDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD1","description":"ICD-CHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pamidronate disodium /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2430","description":"Pamidronate disodium /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF1","description":"ICD-BAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive remover_ wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4456","description":"Adhesive remover_ wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0563T","description":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD0","description":"ICD-KBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC1","description":"ICD-OJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF0","description":"ICD-JHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB1","description":"ICD-JFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC0","description":"ICD-BGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66682","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB0","description":"ICD-BCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37287","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","description":"CPT-37287","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumocystis carinii ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87281","description":"Pneumocystis carinii ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27618","description":"Exc leg/ankle tum < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0022","description":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD0","description":"ICD-OEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF1","description":"ICD-JCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIA0","description":"ICD-OHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB0","description":"ICD-DCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB10","description":"High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped fluid and electrolyte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4103","description":"Ef ped fluid and electrolyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj dupuytren cord w/enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20527","description":"Inj dupuytren cord w/enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47620","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC1","description":"ICD-NBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE1","description":"ICD-GIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27590","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE251","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31578","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81538","description":"Oncology lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE0","description":"ICD-FCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2596","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","description":"HCPCS-J2596","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit resp therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99503","description":"Home visit resp therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tetracyclin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0120","description":"Tetracyclin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE1","description":"ICD-EFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC1","description":"ICD-MACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD1","description":"ICD-CBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA1","description":"ICD-BIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB1","description":"ICD-CBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF0","description":"ICD-GGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE1","description":"ICD-PJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB1","description":"ICD-JFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9890","description":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood type antigen donor ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86902","description":"Blood type antigen donor ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF0","description":"ICD-NAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA1","description":"ICD-FDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery follow-up add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67331","description":"Eye surgery follow-up add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC0","description":"ICD-NHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind ch_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4288","description":"Dermabind ch_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES351","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2041","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","description":"HCPCS-A2041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA0","description":"ICD-KIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Social work visit_ in the ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9127","description":"Social work visit_ in the ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection alemtuzumab 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9979","description":"Injection alemtuzumab 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB0","description":"ICD-LFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE0","description":"ICD-FGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33321","description":"Repair major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorac cont paraspinal uprig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2670","description":"Thorac cont paraspinal uprig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74020","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of elbow or wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29260","description":"Strapping of elbow or wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE0","description":"ICD-AAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstructive sleep apnea mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8900","description":"Obstructive sleep apnea mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9173","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA1","description":"ICD-NDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","description":"HCPCS-Q4439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB1","description":"ICD-CEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE1","description":"ICD-KARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","description":"HCPCS-J9601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC246","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE0","description":"ICD-MGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC1","description":"ICD-MHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fungi identification mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87107","description":"Fungi identification mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC1","description":"ICD-JCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC211","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afamelanotide implant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7352","description":"Afamelanotide implant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF1","description":"ICD-KBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0006","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC1","description":"ICD-GCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF1","description":"ICD-LHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA1","description":"ICD-JFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8030","description":"Limited dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA0","description":"ICD-OEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1597","description":"Injection_ glycopyrrolate (Glyrx-PF)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC1","description":"ICD-KDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1067T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1067T","description":"CPT-1067T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND1","description":"ICD-GIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE0","description":"ICD-JHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA1","description":"ICD-OCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8E","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD1","description":"ICD-BBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31646","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC0","description":"ICD-CETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA0","description":"ICD-OEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin mnl lck ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5811","description":"Endo knee-shin mnl lck ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87580","description":"M.pneumon dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60210","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB0","description":"ICD-OCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD0","description":"ICD-OFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist endoscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29848","description":"Wrist endoscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD0","description":"ICD-FATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF1","description":"ICD-EDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF1","description":"ICD-BABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB31","description":"ICD-4HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lsh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58541","description":"Lsh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF0","description":"ICD-CHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA0","description":"ICD-KEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB212","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE0","description":"ICD-JBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32999","description":"Chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC113","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1447","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","description":"HCPCS-M1447","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of corneal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65450","description":"Treatment of corneal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD1","description":"ICD-MLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF1","description":"ICD-LARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Day habil waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2020","description":"Day habil waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place needle in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36000","description":"Place needle in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of androstenedione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82157","description":"Assay of androstenedione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rb82 rubidium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9555","description":"Rb82 rubidium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE0","description":"ICD-OITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair detachable foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1070","description":"Wheelchair detachable foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244U","description":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9281","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC21","description":"ICD-3FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35201","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB1","description":"ICD-FCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telethx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77306","description":"Telethx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder abduction joint pai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6640","description":"Shoulder abduction joint pai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC1","description":"ICD-KDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE0","description":"ICD-CGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB0","description":"ICD-CGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1017","description":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC0","description":"ICD-KGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76825","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF1","description":"ICD-BAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91111","description":"Esophageal capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE1","description":"ICD-KIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair safety vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0980","description":"Wheelchair safety vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC0","description":"ICD-PFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nabilone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8650","description":"Nabilone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 resin-based compos","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2712","description":"Crown 3/4 resin-based compos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE1","description":"ICD-GCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder fb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4034","description":"Cast sup lng leg cylinder fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD0","description":"ICD-NBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360U","description":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA1","description":"ICD-KCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA0","description":"ICD-OKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0294","description":"Hosp bed semi-elect w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1161","description":"Patient had anaphylaxis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA1","description":"ICD-NJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25250","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0801","description":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9290","description":"No doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA0","description":"ICD-KBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL34","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB0","description":"ICD-FBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD1","description":"ICD-CIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oropharyngeal suction catheter_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4628","description":"Oropharyngeal suction catheter_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA0","description":"ICD-OJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF0","description":"ICD-CGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE0","description":"ICD-GHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC1","description":"ICD-BIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD0","description":"ICD-BDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF0","description":"ICD-BDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36620","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE0","description":"ICD-AADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restrata_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2007","description":"Restrata_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Max MRI image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0385","description":"Max MRI image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF1","description":"ICD-OHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE1","description":"ICD-FDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ank-foot sys dors-plant flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5973","description":"Ank-foot sys dors-plant flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC05","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC0","description":"ICD-BAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE1","description":"ICD-FDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33904","description":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD255","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB1","description":"ICD-MFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69727","description":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC0","description":"ICD-JBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB0","description":"ICD-OALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77423","description":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lev 2 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0381","description":"Lev 2 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA0","description":"ICD-GAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA1","description":"ICD-ODUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC1","description":"ICD-MKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA0","description":"ICD-MALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium nitrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1457","description":"Gallium nitrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55450","description":"Ligation of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME1","description":"ICD-MCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI angio abdom w orw/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74185","description":"MRI angio abdom w orw/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibuloplasty exten graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7350","description":"Vestibuloplasty exten graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47554","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD0","description":"ICD-OHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA1","description":"ICD-BFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA0","description":"ICD-JFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc back les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21930","description":"Exc back les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temporary replacement eqpmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0462","description":"Temporary replacement eqpmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","description":"HCPCS-Q4400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63702","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telethx isodose plan cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77307","description":"Telethx isodose plan cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF0","description":"ICD-BFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD0","description":"ICD-PBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64646","description":"Chemodenerv trunk musc 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit complex cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5501","description":"Hit complex cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain ovary abscess percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58822","description":"Drain ovary abscess percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF0","description":"ICD-IGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC0","description":"ICD-CHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28010","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB1","description":"ICD-GHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0580U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","description":"CPT-0580U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD0","description":"ICD-GFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC113","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumo imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1022F","description":"Pneumo imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB0","description":"ICD-CANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0174","description":"Thiethylperazine maleate10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No beta-lactam abx ther_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9560","description":"No beta-lactam abx ther_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9800","description":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE0","description":"ICD-ACBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9032","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF0","description":"ICD-KCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0B","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise & drain bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51040","description":"Incise & drain bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75807","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40801","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF1","description":"ICD-BAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal 6.1 to 10mg bupre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0574","description":"Bupren/nal 6.1 to 10mg bupre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB0","description":"ICD-KHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA0","description":"ICD-JDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB1","description":"ICD-FFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE1","description":"ICD-IGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB0","description":"ICD-GIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6402","description":"Sterile gauze <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA1","description":"ICD-KBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC1","description":"ICD-NDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD1","description":"ICD-GIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF0","description":"ICD-OKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68760","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE1","description":"ICD-JDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA0","description":"ICD-OCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE0","description":"ICD-HBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE1","description":"ICD-KHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Botulism ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90288","description":"Botulism ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/monitoring and analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93271","description":"Ecg/monitoring and analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB1","description":"ICD-PASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2777","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35703","description":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8C","description":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC131","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens pmma-toric/prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2501","description":"Cntct lens pmma-toric/prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD1","description":"ICD-OIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD1","description":"ICD-LGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chiropractic medicine mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0065","description":"Chiropractic medicine mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA1","description":"ICD-LERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyqvia 100mg immuneglobulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1575","description":"Hyqvia 100mg immuneglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0604","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0604","description":"CDT-D0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dmd dup/delet analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81161","description":"Dmd dup/delet analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB0","description":"ICD-OEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93457","description":"R hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21603","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE0","description":"ICD-GGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB0","description":"ICD-PCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA0","description":"ICD-DBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC1","description":"ICD-OJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB1","description":"ICD-JHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD1","description":"ICD-FDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59412","description":"Antepartum manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cltx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27267","description":"Cltx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA0","description":"ICD-EDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA0","description":"ICD-CDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC0","description":"ICD-JDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF0","description":"ICD-FHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate solution_ non-dex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4728","description":"Dialysate solution_ non-dex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7539","description":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA0","description":"ICD-PAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC1","description":"ICD-OBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA0","description":"ICD-KAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical services after hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99050","description":"Medical services after hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE1","description":"ICD-LBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB0","description":"ICD-ACBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF0","description":"ICD-JHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bed cradle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0280","description":"Bed cradle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0406","description":"HCPCS-A0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect scapula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23210","description":"Resect scapula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC1","description":"ICD-GCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Monthly Maintenance)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1895","description":"Personal Emergency Response System (Monthly Maintenance)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0988T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","description":"CPT-0988T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB0","description":"ICD-OAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/svc dme non-oxygen eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0739","description":"Repair/svc dme non-oxygen eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA0","description":"ICD-ODHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF0","description":"ICD-NBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad dos limts b/4 3d rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520F","description":"Rad dos limts b/4 3d rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE1","description":"ICD-NIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC1","description":"ICD-KFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA0","description":"ICD-OGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carbon graphite lamination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2755","description":"Carbon graphite lamination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66179","description":"Aqueous shunt eye w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE1","description":"ICD-JIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0617","description":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC1","description":"ICD-PFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histrelin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1675","description":"Histrelin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-surg tx root canal obs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3331","description":"Non-surg tx root canal obs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431U","description":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25444","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC0","description":"ICD-JIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA0","description":"ICD-BDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD0","description":"ICD-KHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD1","description":"ICD-HCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF0","description":"ICD-OAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protector heel or elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0191","description":"Protector heel or elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC1","description":"ICD-NIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF0","description":"ICD-HISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC0","description":"ICD-KHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD1","description":"ICD-MATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9887","description":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD0","description":"ICD-OFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC1","description":"ICD-OJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD0","description":"ICD-HGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxychloroquine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80220","description":"Hydroxychloroquine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF0","description":"ICD-CCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB1","description":"ICD-GIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC0","description":"ICD-ABBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE0","description":"ICD-CEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB1","description":"ICD-NKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannula nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4615","description":"Cannula nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23330","description":"Remove shoulder foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF1","description":"ICD-OGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA1","description":"ICD-GFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx periorbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21386","description":"Opn tx orbit fx periorbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9484","description":"Injection_ eteplirsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33365","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mosunetuzumab-axgb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9350","description":"Injection_ mosunetuzumab-axgb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA1","description":"ICD-AFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00529","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","description":"CPT-00529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB1","description":"ICD-GIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4438","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6950","description":"Above elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5C","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69720","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF1","description":"ICD-OLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD0","description":"ICD-FEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0610","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF1","description":"ICD-IGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC0","description":"ICD-BBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Loxapine for inhalation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2062","description":"Loxapine for inhalation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF1","description":"ICD-CBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC0","description":"ICD-AIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF0","description":"ICD-EGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF1","description":"ICD-DEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB1","description":"ICD-CFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit fecal/enema mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99511","description":"Home visit fecal/enema mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foll-up eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9562","description":"Foll-up eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD1","description":"ICD-NJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2596","description":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE0","description":"ICD-OBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74470","description":"X-ray exam of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supported housing_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0043","description":"Supported housing_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD1","description":"ICD-CGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB1","description":"ICD-BEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96112","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF0","description":"ICD-LIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA1","description":"ICD-FGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD0","description":"ICD-GAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF1","description":"ICD-FETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD1","description":"ICD-FEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC106","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE0","description":"ICD-CGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA0","description":"ICD-PDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","description":"HCPCS-G0567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99600","description":"Home visit nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evidence-based therapy was prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1227","description":"Evidence-based therapy was prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD0","description":"ICD-OIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0614U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","description":"CPT-0614U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC1","description":"ICD-CBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair prosthesis per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7520","description":"Repair prosthesis per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF1","description":"ICD-GDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA0","description":"ICD-MDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA0","description":"ICD-KGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE0","description":"ICD-GBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nikaidoh proc w/ostia implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33783","description":"Nikaidoh proc w/ostia implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD0","description":"ICD-GCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA1","description":"ICD-EFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD0","description":"ICD-HGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem urinary collect pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4328","description":"Fem urinary collect pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient discharged alive following endovascular AAA repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9263","description":"Documentation of patient discharged alive following endovascular AAA repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41116","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB11","description":"ICD-2IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long chain fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82726","description":"Long chain fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of small int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2053","description":"Transplantation of small int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB1","description":"ICD-AGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3D","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90619","description":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC24","description":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dementia mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8761","description":"Dementia mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB21","description":"ICD-1AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB44","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE113","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE1","description":"ICD-MIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249U","description":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0303","description":"CDT-D0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE0","description":"ICD-CCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle/heel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28100","description":"Removal of ankle/heel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33858","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB1","description":"ICD-CIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD0","description":"ICD-FCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1902","description":"HCPCS-A1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF1","description":"ICD-FGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE0","description":"ICD-MLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57720","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for future fall risk_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1070","description":"Patient not screened for future fall risk_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE0","description":"ICD-OIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB1","description":"ICD-GDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB0","description":"ICD-NKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA0","description":"ICD-OKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE0","description":"ICD-AHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-electr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0628","description":"Seat lift for pt furn-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE1","description":"ICD-HCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97157","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"U/s trtmt_ not leiomyomata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9734","description":"U/s trtmt_ not leiomyomata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx radial 3+ frag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25609","description":"Treat fx radial 3+ frag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate metacarpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26910","description":"Amputate metacarpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht irrigation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9590","description":"Ht irrigation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC0","description":"ICD-NLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC1","description":"ICD-ECMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17266","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA0","description":"ICD-OCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27290","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB1","description":"ICD-AILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF0","description":"ICD-JFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND1","description":"ICD-BGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8918","description":"Mra w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58321","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD241","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC0","description":"ICD-KBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB1","description":"ICD-BCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE136","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","description":"HCPCS-A2028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0649T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0804","description":"HCPCS-C0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61534","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0824T","description":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1601","description":"HCPCS-B1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD0","description":"ICD-IBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA211","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB1","description":"ICD-BHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for elbow x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24220","description":"Injection for elbow x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; carotid sinus (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64508","description":"Injection_ anesthetic agent; carotid sinus (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX17","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dimecaprol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0470","description":"Dimecaprol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD1","description":"ICD-KDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB0","description":"ICD-NGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB1","description":"ICD-HHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99357","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA1","description":"ICD-JCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3762F","description":"Patient is dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sys<140 and dia<90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9273","description":"Sys<140 and dia<90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC225","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD1","description":"ICD-NJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA0","description":"ICD-KIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine & cord cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63194","description":"Incise spine & cord cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA0","description":"ICD-NECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0325U","description":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCA1","description":"ICD-JHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE1","description":"ICD-JINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9352","description":"Not >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee detach ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1172","description":"Wheelchair amputee detach ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD1","description":"ICD-NEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF0","description":"ICD-JANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96548","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculate tissue addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87253","description":"Virus inoculate tissue addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27840","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB0","description":"ICD-MEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD1","description":"ICD-HBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","description":"CPT-00844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC0","description":"ICD-JILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE1","description":"ICD-OIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE1","description":"ICD-DDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE1","description":"ICD-GCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC1","description":"ICD-FBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28295","description":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB1","description":"ICD-NCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD0","description":"ICD-GHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15277","description":"Skn sub grft f/n/hf/g child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess hghlymalig doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3345F","description":"Mammo assess hghlymalig doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9355","description":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screen depression performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3725F","description":"Screen depression performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF1","description":"ICD-NIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE0","description":"ICD-HGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA0","description":"ICD-GCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0517","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF1","description":"ICD-OBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home vent mgmt supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94005","description":"Home vent mgmt supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot external keel sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5970","description":"Foot external keel sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD260","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heparin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85520","description":"Heparin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB0","description":"ICD-HCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repeat drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33011","description":"Repeat drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21155","description":"Lefort iii w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME0","description":"ICD-BBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD1","description":"ICD-KBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA30","description":"Medium Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE1","description":"ICD-EHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1003","description":"Pwr seat recline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7507","description":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC0","description":"ICD-DBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE1","description":"ICD-DAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tub stool or bench","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0245","description":"Tub stool or bench","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00904","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","description":"CPT-00904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychiatric symp absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1183F","description":"Neuropsychiatric symp absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5B","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE0","description":"ICD-IGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil sup empl waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2018","description":"Habil sup empl waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC0","description":"ICD-FAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","description":"CPT-00865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal_ with contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9744","description":"Ultrasound_ abdominal_ with contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40840","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD0","description":"ICD-GHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0643U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0643U","description":"CPT-0643U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB0","description":"ICD-OINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular rehab per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9476","description":"Vestibular rehab per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aducanumab-avwa_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0172","description":"Injection_ aducanumab-avwa_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acyclovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0133","description":"Acyclovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA1","description":"ICD-IIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE0","description":"ICD-MFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01992","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","description":"CPT-01992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF0","description":"ICD-HCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD226","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA0","description":"ICD-LCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6240","description":"Bridge porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED1","description":"ICD-AAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","description":"HCPCS-L6031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA0","description":"ICD-MHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA0","description":"ICD-NANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF0","description":"ICD-PGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27393","description":"Lengthening of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB1","description":"ICD-DFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB36","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC1","description":"ICD-EFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC0","description":"ICD-OEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of folic acid serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82746","description":"Assay of folic acid serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE1","description":"ICD-OEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of triglycerides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84478","description":"Assay of triglycerides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6259","description":"Transparent film > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place perm pacing cardiovert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0448","description":"Place perm pacing cardiovert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3915","description":"Who nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE0","description":"ICD-KIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC52","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC1","description":"ICD-BGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor xiii recomb a-subunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7181","description":"Factor xiii recomb a-subunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27888","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE0","description":"ICD-OFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD0","description":"ICD-OBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD1","description":"ICD-BDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Root canal therapy 2 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3320","description":"Root canal therapy 2 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE1","description":"ICD-KHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open aortoiliac prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34831","description":"Open aortoiliac prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD241","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC0","description":"ICD-KGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho flex frejka w/cov pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1600","description":"Ho flex frejka w/cov pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD1","description":"ICD-JBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore sinus remove polyps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31032","description":"Explore sinus remove polyps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC0","description":"ICD-NBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4B","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA1","description":"ICD-AEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE1","description":"ICD-CGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair no. 2 footplates","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0970","description":"Wheelchair no. 2 footplates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB0","description":"ICD-MCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hg a1c level lt 7.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3044F","description":"Hg a1c level lt 7.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27824","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provisional splint extracoro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4321","description":"Provisional splint extracoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID1","description":"ICD-AIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC0","description":"ICD-CAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE0","description":"ICD-LGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD0","description":"ICD-JIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF0","description":"ICD-FDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE0","description":"ICD-GHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA0","description":"ICD-OLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0554U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","description":"CPT-0554U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1100","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE0","description":"ICD-JIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40805","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA0","description":"ICD-PCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED1","description":"ICD-BBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provisional retainer crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6793","description":"Provisional retainer crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10081","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED0","description":"ICD-NFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0754T","description":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low extemity neur exam docum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8404","description":"Low extemity neur exam docum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF0","description":"ICD-CAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE1","description":"ICD-FETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE1","description":"ICD-PLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23030","description":"Drain shoulder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC1","description":"ICD-LAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80503","description":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF1","description":"ICD-GAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA42","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt in the home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9131","description":"Pt in the home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC1","description":"ICD-MGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4562F","description":"Pt w/o coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part pulp for apexogenesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3222","description":"Part pulp for apexogenesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA1","description":"ICD-CAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Energy storing foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5976","description":"Energy storing foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC1","description":"ICD-CDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0138","description":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF1","description":"ICD-JCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA0","description":"ICD-GINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA1","description":"ICD-MAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one well-child visit with a PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9964","description":"Patient received at least one well-child visit with a PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15733","description":"Muscle_ myocutaneous_ or fasciocutaneous flap; head and neck with named vascular pedicle (ie_ buccinators_ genioglossus_ temporalis_ masseter_ sternocleidomastoid_ levator sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","description":"HCPCS-E1814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54640","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sup fee antiem_antica_immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0511","description":"Sup fee antiem_antica_immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED0","description":"ICD-JFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1018","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0642T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB0","description":"ICD-FEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE1","description":"ICD-GECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF1","description":"ICD-JAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC25","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complement fixation each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86171","description":"Complement fixation each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF1","description":"ICD-LISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD0","description":"ICD-CHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelvis les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27047","description":"Exc hip/pelvis les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0858T","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE1","description":"ICD-OBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD1","description":"ICD-BFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC0","description":"ICD-JGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fistula repair transperine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57308","description":"Fistula repair transperine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF1","description":"ICD-AHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70490","description":"Ct soft tissue neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photorefractive keratectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0810","description":"Photorefractive keratectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB1","description":"ICD-BCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1340","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE1","description":"ICD-PGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF0","description":"ICD-GEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bivalirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0583","description":"Bivalirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8049","description":"Repair maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heroin metabolite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80356","description":"Heroin metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE0","description":"ICD-BECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF0","description":"ICD-OGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA0","description":"ICD-CECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp genet test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3865","description":"Comp genet test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","description":"HCPCS-J3389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent w/angio addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92929","description":"Prq card stent w/angio addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID0","description":"ICD-ICID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA32","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA0","description":"ICD-HBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC0","description":"ICD-AFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC1","description":"ICD-KBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2220","description":"Lens bifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF1","description":"ICD-ECCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91300","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF0","description":"ICD-FEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft t/a/l child add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15274","description":"Skn sub grft t/a/l child add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB21","description":"ICD-4KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clear eyelid gland w/heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207T","description":"Clear eyelid gland w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD136","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA1","description":"ICD-NGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA0","description":"ICD-GCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA0","description":"ICD-ABTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD1","description":"ICD-GBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA0","description":"ICD-OKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin cartridge 300 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5566","description":"Insulin cartridge 300 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ashkenazi jewish assoc dis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81412","description":"Ashkenazi jewish assoc dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB1","description":"ICD-BEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF1","description":"ICD-KEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD1","description":"ICD-ODGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00566","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","description":"CPT-00566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC0","description":"ICD-EFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC1","description":"ICD-DCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF0","description":"ICD-GGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA1","description":"ICD-JCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB1","description":"ICD-GBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB0","description":"ICD-BIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF0","description":"ICD-MBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76145","description":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47712","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-evalest ptproblem focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0170","description":"Re-evalest ptproblem focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevat proximal arm support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2631","description":"Elevat proximal arm support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No prol intub req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8570","description":"No prol intub req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA1","description":"ICD-IHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD0","description":"ICD-OBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC0","description":"ICD-FEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC0","description":"ICD-OFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA1","description":"ICD-KFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA0","description":"ICD-EECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE0","description":"ICD-CHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA0","description":"ICD-EIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA1","description":"ICD-EEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB0","description":"ICD-OACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC1","description":"ICD-MITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures maxill part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5213","description":"Dentures maxill part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic cavernosometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54231","description":"Dynamic cavernosometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE1","description":"ICD-JIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC1","description":"ICD-JHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone length studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77073","description":"X-rays bone length studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF0","description":"ICD-EHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87555","description":"M.tuberculo dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC1","description":"ICD-DEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID0","description":"ICD-MLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID1","description":"ICD-OHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23075","description":"Exc shoulder les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70260","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0661U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0661U","description":"CPT-0661U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9809","description":"HCPCS-C9809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD212","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41100","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD1","description":"ICD-JHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0557U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","description":"CPT-0557U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC1","description":"ICD-FEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD117","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA17","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","description":"HCPCS-M1432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93792","description":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF1","description":"ICD-OERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF0","description":"ICD-NJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB0","description":"ICD-PASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML55","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF1","description":"ICD-FFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB1","description":"ICD-PAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA0","description":"ICD-AGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28530","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2178","description":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022A","description":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1946","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1946","description":"HCPCS-J1946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID0","description":"ICD-IDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1947","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1947","description":"HCPCS-J1947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0431","description":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Azacitidine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9025","description":"Azacitidine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt instr no bd rest 4 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4248F","description":"Pt instr no bd rest 4 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mdd in remission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3092F","description":"Mdd in remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA0","description":"ICD-MJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF0","description":"ICD-KESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8653","description":"Fun stat score hip pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mold socket bent knee shin s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5160","description":"Mold socket bent knee shin s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD1","description":"ICD-MGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD0","description":"ICD-NFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE1","description":"ICD-FBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB1","description":"ICD-NFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF1","description":"ICD-OLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for artery repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76936","description":"Echo guide for artery repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED0","description":"ICD-BIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF0","description":"ICD-MITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove maxilla cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21048","description":"Remove maxilla cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67906","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC11","description":"ICD-1IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27240","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD1","description":"ICD-OGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED1","description":"ICD-KCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES110","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE0","description":"ICD-ODIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00541","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","description":"CPT-00541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB0","description":"ICD-PLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED1","description":"ICD-GFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF0","description":"ICD-NKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC0","description":"ICD-OEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE0","description":"ICD-CDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8E","description":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA1","description":"ICD-KEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Organic acids total quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83918","description":"Organic acids total quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA1","description":"ICD-GCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA0","description":"ICD-GDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE1","description":"ICD-OFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA1","description":"ICD-KFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA0","description":"ICD-NLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34704","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nk cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86357","description":"Nk cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4350","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","description":"HCPCS-Q4350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42890","description":"Partial removal of pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE0","description":"ICD-OFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1090","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA1","description":"ICD-GHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29851","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC0","description":"ICD-ADDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA1","description":"ICD-OJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21088","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9990","description":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE1","description":"ICD-GBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF0","description":"ICD-BCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC1","description":"ICD-LGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF1","description":"ICD-IBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF0","description":"ICD-NBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE0","description":"ICD-FFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ed svc ckd grp per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0421","description":"Ed svc ckd grp per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB1","description":"ICD-JHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF0","description":"ICD-KDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD1","description":"ICD-JAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8D","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC0","description":"ICD-KGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF1","description":"ICD-GDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE1","description":"ICD-KCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/explr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47564","description":"Laparo cholecystectomy/explr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Betamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7624","description":"Betamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38212","description":"Rbc depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA0","description":"ICD-KILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD1","description":"ICD-NGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2640","description":"Brachytx_ stranded_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA1","description":"ICD-GCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25446","description":"Wrist replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4270","description":"Complete sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB13","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF0","description":"ICD-MIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","description":"HCPCS-Q4371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB0","description":"ICD-NBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA0","description":"ICD-LFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB0","description":"ICD-BIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD1","description":"ICD-ECTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA0","description":"ICD-MFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99344","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35452","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24361","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA1","description":"ICD-BACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB1","description":"ICD-NGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL17","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of abdomen artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37617","description":"Ligation of abdomen artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ sculptra_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2028","description":"Inj_ sculptra_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB1","description":"ICD-KGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rubeola ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87283","description":"Rubeola ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rickettsia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86757","description":"Rickettsia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-META1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META1","description":"ICD-META1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0128U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC1","description":"ICD-ODSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0886T","description":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD0","description":"ICD-PFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Botulinum antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90287","description":"Botulinum antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA1","description":"ICD-GIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB1","description":"ICD-CAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC0","description":"ICD-NFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC0","description":"ICD-NGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta techl sprt min 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0605T","description":"Rem oct rta techl sprt min 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB0","description":"ICD-BHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB1","description":"ICD-EBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB0","description":"ICD-OCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID0","description":"ICD-OEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF0","description":"ICD-BFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE0","description":"ICD-GGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB1","description":"ICD-GHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA1","description":"ICD-NDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA1","description":"ICD-CIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrodes_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4556","description":"Electrodes_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap w/omentopexy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49326","description":"Lap w/omentopexy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF0","description":"ICD-PBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE145","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF1","description":"ICD-CISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF0","description":"ICD-GIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB0","description":"ICD-CHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD1","description":"ICD-NDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF0","description":"ICD-JDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE221","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF0","description":"ICD-GHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE1","description":"ICD-CFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indirect immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0483","description":"Indirect immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig; scrn clin dep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8433","description":"Pt inelig; scrn clin dep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF1","description":"ICD-FCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tigecycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3243","description":"Tigecycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC1","description":"ICD-NITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD1","description":"ICD-KETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA1","description":"ICD-KHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB0","description":"ICD-EGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE1","description":"ICD-OCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt edu re alcoh drnkng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4158F","description":"Pt edu re alcoh drnkng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65865","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21490","description":"Repair dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC1","description":"ICD-BBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq art m-thrombect &/nfs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61645","description":"Perq art m-thrombect &/nfs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC0","description":"ICD-FCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC0","description":"ICD-GEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect prox humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23220","description":"Resect prox humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE1","description":"ICD-GEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD1","description":"ICD-KCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditory function + 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92621","description":"Auditory function + 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA1","description":"ICD-CCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB0","description":"ICD-KFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain cerebro spinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62272","description":"Drain cerebro spinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Homaker service nos per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5130","description":"Homaker service nos per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add proc construct new crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2971","description":"Add proc construct new crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE0","description":"ICD-OJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tyrosine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84510","description":"Assay of tyrosine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of 5-hiaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83497","description":"Assay of 5-hiaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27138","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF0","description":"ICD-KEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33501","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB14","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA0","description":"ICD-GBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID0","description":"ICD-KFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7542","description":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF0","description":"ICD-OIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temozolomide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8700","description":"Temozolomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB1","description":"ICD-BFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33692","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transducer protect/fld bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1575","description":"Transducer protect/fld bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB1","description":"ICD-OKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0235","description":"Pet not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA1","description":"ICD-FGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB0","description":"ICD-MLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Torsion ank & half solid sti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2375","description":"Torsion ank & half solid sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB0","description":"ICD-MHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB0","description":"ICD-JFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE0","description":"ICD-IATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD1","description":"ICD-JBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polysom 6/>yrs cpap 4/> parm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95811","description":"Polysom 6/>yrs cpap 4/> parm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93264","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm procure subs visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4031","description":"Sperm procure subs visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA0","description":"ICD-KAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4364","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","description":"HCPCS-Q4364","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neox 100 or Clarix 100_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4156","description":"Neox 100 or Clarix 100_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant eye drug system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67027","description":"Implant eye drug system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF0","description":"ICD-GFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 1 lobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31660","description":"Bronch thermoplsty 1 lobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49189","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","description":"CPT-49189","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE1","description":"ICD-NGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programmable infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0783","description":"Programmable infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD236","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD0","description":"ICD-MBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF0","description":"ICD-OHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w iv ab not given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8917","description":"Pt w iv ab not given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA0","description":"ICD-CFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test for g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82960","description":"Test for g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0202","description":"HCPCS-B0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61253","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenting class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9444","description":"Parenting class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE0","description":"ICD-NBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA0","description":"ICD-OLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC0","description":"ICD-CIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD0","description":"ICD-MHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdr elctr ntrst/ntrcv brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395T","description":"Hdr elctr ntrst/ntrcv brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA0","description":"ICD-EAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA44","description":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj sciatic sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64445","description":"N block inj sciatic sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA1","description":"ICD-HGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB15","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20705","description":"Removal Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 loc hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81382","description":"Hla ii typing 1 loc hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE1","description":"ICD-IETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF0","description":"ICD-KGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME1","description":"ICD-KCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC0","description":"ICD-FBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA0","description":"ICD-OFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF0","description":"ICD-ODTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC1","description":"ICD-EITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB1","description":"ICD-JEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61514","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE1","description":"ICD-GGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD1","description":"ICD-CFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA0","description":"ICD-JDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE1","description":"ICD-JAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27500","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX03","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE0","description":"ICD-NDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF1","description":"ICD-JEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ampicillin sodium per 1.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0295","description":"Ampicillin sodium per 1.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA1","description":"ICD-JBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB0","description":"ICD-OCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD1","description":"ICD-CHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0086U","description":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4406","description":"Pectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA1","description":"ICD-KCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intens cardiac rehab no exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0423","description":"Intens cardiac rehab no exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB1","description":"ICD-IFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9949","description":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv sr wire occ/man pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0160","description":"Cerv sr wire occ/man pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA1","description":"ICD-NAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF0","description":"ICD-PDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC0","description":"ICD-CHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","description":"HCPCS-J1370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA1","description":"ICD-OIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0048U","description":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081U","description":"Onc Uveal MLNMA MRNA gen xprs prfl 15 gene alg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26045","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55845","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA0","description":"ICD-CCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test one limb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95860","description":"Muscle test one limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC0","description":"ICD-IBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24130","description":"Removal of head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ifosfamide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9208","description":"Ifosfamide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB0","description":"ICD-NKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0114U","description":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5942","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5942","description":"CDT-D5942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26476","description":"Tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA0","description":"ICD-FIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8D","description":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD0","description":"ICD-MJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not die within 30 days of the procedure or during the index hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9813","description":"Patient did not die within 30 days of the procedure or during the index hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7298","description":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral knee autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27416","description":"Osteochondral knee autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98941","description":"Chiropract manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl multifoc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92353","description":"Fit aphakia spectcl multifoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoid synthetic 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80352","description":"Cannabinoid synthetic 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7030","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF1","description":"ICD-KDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82491","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenobarbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80184","description":"Assay of phenobarbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth procedure on mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17051","description":"Anesth procedure on mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE0","description":"ICD-DAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF1","description":"ICD-CCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC0","description":"ICD-FECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq transcath septal reduxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93583","description":"Perq transcath septal reduxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB0","description":"ICD-DFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA1","description":"ICD-FDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF0","description":"ICD-MLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX24","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/ove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2206","description":"Lens sphcy bifocal 4.00d/ove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 3 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP03","description":"Auto.test pane pricing code_ 3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0594U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","description":"CPT-0594U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD1","description":"ICD-DCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35021","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE1","description":"ICD-MEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4016","description":"Cast sup gauntlet ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB0","description":"ICD-BFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rectal sensation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91120","description":"Rectal sensation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD0","description":"ICD-GDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA1","description":"ICD-PGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA0","description":"ICD-BAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36260","description":"Insertion of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA0","description":"ICD-GEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ova and parasites smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87177","description":"Ova and parasites smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1404","description":"CDT-D1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2641","description":"Brachytx_ non-stranded_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC1","description":"ICD-OLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5105","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft head/neck seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63050","description":"Cervical laminoplsty 2/> seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB0","description":"ICD-MLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33845","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC0","description":"ICD-IIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC0","description":"ICD-KCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF1","description":"ICD-BBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF1","description":"ICD-HIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE0","description":"ICD-FEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE1","description":"ICD-AETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta blckr admin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4115F","description":"Beta blckr admin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stenger test speech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92577","description":"Stenger test speech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB0","description":"ICD-JHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC1","description":"ICD-NIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE0","description":"ICD-MJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF0","description":"ICD-LGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF1","description":"ICD-OFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE0","description":"ICD-DAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0401","description":"HCPCS-B0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF1","description":"ICD-OEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9941","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of lip fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40806","description":"Incision of lip fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA1","description":"ICD-ECTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair wrist joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25447","description":"Repair wrist joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA1","description":"ICD-ECUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA0","description":"ICD-FAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery correction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33502","description":"Coronary artery correction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuromend nerve wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9361","description":"Neuromend nerve wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37246","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB0","description":"ICD-NLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB0","description":"ICD-BIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81436","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC0","description":"ICD-OFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA1","description":"ICD-ICTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF1","description":"ICD-JGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1018T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","description":"CPT-1018T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE135","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cervic collar w air bladders","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0856","description":"Cervic collar w air bladders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53020","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2156","description":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD0","description":"ICD-NKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA0","description":"ICD-FIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sweat sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84302","description":"Assay of sweat sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amifostine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0207","description":"Amifostine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA1","description":"ICD-MAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calcitonin salmon injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0630","description":"Calcitonin salmon injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vis item/svc in other code","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2797","description":"Vis item/svc in other code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC0","description":"ICD-AFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal biophys profil w/o nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76819","description":"Fetal biophys profil w/o nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA0","description":"ICD-KCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB1","description":"ICD-OLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA1","description":"ICD-BIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB1","description":"ICD-JAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE1","description":"ICD-CFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB1","description":"ICD-JDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD0","description":"ICD-CCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE1","description":"ICD-ODDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB0","description":"ICD-OEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lurbinectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9223","description":"Injection_ lurbinectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD1","description":"ICD-KESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA1","description":"ICD-OEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF1","description":"ICD-CGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF0","description":"ICD-NIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA0","description":"ICD-CACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93925","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3272F","description":"Med risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wet mounts/ w preparations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0111","description":"Wet mounts/ w preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE1","description":"ICD-BBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87550","description":"Mycobacteria dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD0","description":"ICD-GASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt cath w/ventriclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93453","description":"R&l hrt cath w/ventriclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA0","description":"ICD-EDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25393","description":"Lengthen radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1832","description":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0A","description":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF1","description":"ICD-EFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA0","description":"ICD-KCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1478","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","description":"HCPCS-M1478","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE0","description":"ICD-KFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add march bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3595","description":"Ortho shoe add march bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF1","description":"ICD-EIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA31","description":"ICD-2CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD1","description":"ICD-JGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC1","description":"ICD-EEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC0","description":"ICD-OLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped critical care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99471","description":"Ped critical care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semi-precision abutment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6191","description":"Semi-precision abutment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE230","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE206","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","description":"HCPCS-M1386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27407","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk removable medial brim sus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5672","description":"Bk removable medial brim sus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9403","description":"Doc reas no 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD1","description":"ICD-FDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD0","description":"ICD-ODCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF1","description":"ICD-NLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc to have fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8910","description":"Pt doc to have fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC0","description":"ICD-CFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine4/>vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72074","description":"X-ray exam thorac spine4/>vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1446","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","description":"HCPCS-M1446","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation at shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23920","description":"Amputation at shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX03","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmchoPlast_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4316","description":"AmchoPlast_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39010","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD1","description":"ICD-GELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L7406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","description":"HCPCS-L7406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE0","description":"ICD-EBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB1","description":"ICD-KGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system gas portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0430","description":"Oxygen system gas portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB42","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB0","description":"ICD-OEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA1","description":"ICD-CFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9066","description":"Injection_ sacituzumab govitecan-hziy_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD0","description":"ICD-MATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE1","description":"ICD-CFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87811","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj midazolam hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2250","description":"Inj midazolam hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Im admin each addl component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90461","description":"Im admin each addl component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA1","description":"ICD-AAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chap services at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9473","description":"Chap services at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE0","description":"ICD-MITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF1","description":"ICD-NIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA1","description":"ICD-KGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB0","description":"ICD-FBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB1","description":"ICD-NBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1084","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB1","description":"ICD-IEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD1","description":"ICD-FDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB07","description":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA1","description":"ICD-CCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD1","description":"ICD-KDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD1","description":"ICD-JCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA0","description":"ICD-OKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC0","description":"ICD-JGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE0","description":"ICD-OJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas not rec hcv srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9385","description":"Doc pt reas not rec hcv srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC256","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF1","description":"ICD-KGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50820","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC255","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB0","description":"ICD-OERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84202","description":"Assay rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us guide vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76937","description":"Us guide vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMD1","description":"ICD-IEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69646","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled nitric oxide meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95012","description":"Exhaled nitric oxide meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC1","description":"ICD-ACBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC1","description":"ICD-OEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place device impacted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7283","description":"Place device impacted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intestine transplant live","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44136","description":"Intestine transplant live","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lincomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2010","description":"Lincomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery translocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33506","description":"Repair artery translocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC0","description":"ICD-CGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg <4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64892","description":"Nerve graft arm/leg <4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA1","description":"ICD-IIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE0","description":"ICD-HISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate esophagus 1/mult pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43450","description":"Dilate esophagus 1/mult pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA1","description":"ICD-FAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53453","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr epigastric hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49570","description":"Rpr epigastric hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6115","description":"Implnt/abut fixed dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC0","description":"ICD-LHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA1","description":"ICD-NGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pw actuator replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2378","description":"Pw actuator replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranio/maxillofacial surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21299","description":"Cranio/maxillofacial surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC1","description":"ICD-OBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD1","description":"ICD-FBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC0","description":"ICD-HBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB254","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA0","description":"ICD-HEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF1","description":"ICD-BFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA1","description":"ICD-PIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE1","description":"ICD-DEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6541","description":"Gc stocking waistlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE1","description":"ICD-KDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF1","description":"ICD-NHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guidance for radiaj tx dlvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77387","description":"Guidance for radiaj tx dlvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD1","description":"ICD-DBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC0","description":"ICD-CFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj chem not pres rsn spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8928","description":"Adj chem not pres rsn spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91312","description":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE1","description":"ICD-NHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD1","description":"ICD-KFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB0","description":"ICD-LERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE0","description":"ICD-FDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD1","description":"ICD-KEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF0","description":"ICD-JDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1360","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive chest wall surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19272","description":"Extensive chest wall surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD113","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC0","description":"ICD-JDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB0","description":"ICD-OAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28226","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31201","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA0","description":"ICD-IGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 4/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2664","description":"Dental onlay resin 4/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap part colectomy w/stoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44206","description":"Lap part colectomy w/stoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES345","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED0","description":"ICD-GFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","description":"HCPCS-Q4406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC31","description":"ICD-1HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19285","description":"Perq dev breast 1st us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC1","description":"ICD-NACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor wght kininogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85293","description":"Clot factor wght kininogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue homogenization cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87176","description":"Tissue homogenization cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0105","description":"HCPCS-B0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0248U","description":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kerecis Omega3_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4158","description":"Kerecis Omega3_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27676","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD1","description":"ICD-LEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA1","description":"ICD-CCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB1","description":"ICD-BDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC1","description":"ICD-AAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF0","description":"ICD-DARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC0","description":"ICD-KEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA0","description":"ICD-IAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC0","description":"ICD-KBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1026","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF0","description":"ICD-OAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infect control supplies nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8301","description":"Infect control supplies nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF1","description":"ICD-CDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Outpt iv insulin tx any mea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9147","description":"Outpt iv insulin tx any mea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lateral thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1210","description":"Lateral thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ileostomy/jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44310","description":"Ileostomy/jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD1","description":"ICD-FCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD216","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD1","description":"ICD-IBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quinupristin/dalfopristin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2770","description":"Quinupristin/dalfopristin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF0","description":"ICD-GCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE114","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5118","description":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC1","description":"ICD-JHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43124","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD1","description":"ICD-NEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect apical lung tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32503","description":"Resect apical lung tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB0","description":"ICD-BIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4C","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF0","description":"ICD-GIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24400","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Front castr compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0071","description":"Front castr compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD1","description":"ICD-MLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63308","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF0","description":"ICD-FETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE0","description":"ICD-IAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL36","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0304","description":"CDT-D0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Res_ nos waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2033","description":"Res_ nos waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE1","description":"ICD-KEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak/hip knee extens assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5850","description":"Endo ak/hip knee extens assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic pulpotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3220","description":"Therapeutic pulpotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD0","description":"ICD-OJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD0","description":"ICD-GBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB0","description":"ICD-JAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB1","description":"ICD-MHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC0","description":"ICD-GDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE0","description":"ICD-AFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8844","description":"No ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD1","description":"ICD-DHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27257","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect mediastinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39200","description":"Resect mediastinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD0","description":"ICD-MFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF1","description":"ICD-JAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81415","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB0","description":"ICD-CABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No recd cortico>=10mg/d >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9468","description":"No recd cortico>=10mg/d >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB21","description":"ICD-2LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD0","description":"ICD-DGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61750","description":"Incise skull/brain biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD0","description":"ICD-HIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB1","description":"ICD-GIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40510","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9177","description":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol hepatic fream","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5200","description":"Parenteral sol hepatic fream","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55877","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","description":"CPT-55877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD1","description":"ICD-IEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0689U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689U","description":"CPT-0689U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pertussis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87265","description":"Pertussis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA1","description":"ICD-CAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic type socket molde","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2350","description":"Prosthetic type socket molde","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97156","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year sperm/semen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89343","description":"Storage/year sperm/semen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE0","description":"ICD-OHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE1","description":"ICD-OGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20912","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE1","description":"ICD-CHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc funct no deficiencies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8542","description":"Doc funct no deficiencies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thaw cryoprsvrd reprod tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89354","description":"Thaw cryoprsvrd reprod tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA0","description":"ICD-ODRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA1","description":"ICD-EBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft time of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6104","description":"Bone graft time of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE1","description":"ICD-FFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA1","description":"ICD-KFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA0","description":"ICD-PGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of rectal narrowing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45910","description":"Dilation of rectal narrowing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB0","description":"ICD-OLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydromorphone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1170","description":"Hydromorphone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA1","description":"ICD-LGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1025","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9296","description":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33971","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7670","description":"Metaproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA0","description":"ICD-OGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE0","description":"ICD-FHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nitroglycerin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2305","description":"Injection_ nitroglycerin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA1","description":"ICD-AEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC245","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC0","description":"ICD-IFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA1","description":"ICD-JHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC0","description":"ICD-BDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF0","description":"ICD-GGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF1","description":"ICD-DAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB1","description":"ICD-JIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker leg extenders set of4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0158","description":"Walker leg extenders set of4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0205","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0205","description":"CDT-D0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23184","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31360","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB1","description":"ICD-CGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobile arm supports reclinin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2628","description":"Mobile arm supports reclinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE0","description":"ICD-GGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF1","description":"ICD-PHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2113","description":"Spherocylindr 7.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD1","description":"ICD-NGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32440","description":"Remove lung pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF1","description":"ICD-FAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC0","description":"ICD-HFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE1","description":"ICD-GFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88152","description":"Cytopath c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF0","description":"ICD-OJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC0","description":"ICD-BBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB0","description":"ICD-DCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA1","description":"ICD-OEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44377","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB1","description":"ICD-NKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21348","description":"Opn tx nasomax fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF0","description":"ICD-CCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20902","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD1","description":"ICD-CBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21315","description":"Closed tx nose fx w/o stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv unl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338T","description":"Trnscth renal symp denrv unl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD1","description":"ICD-BGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC0","description":"ICD-FHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8D","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF0","description":"ICD-MJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD1","description":"ICD-GHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC40","description":"Medium Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5638","description":"Below knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC1","description":"ICD-JCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220T","description":"Plmt post facet implt thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smear gram stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87205","description":"Smear gram stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64702","description":"Revise finger/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB0","description":"ICD-GEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport mini-bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0120","description":"Noner transport mini-bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB1","description":"ICD-IAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8F","description":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF1","description":"ICD-HCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD0","description":"ICD-MCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1021","description":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC0","description":"ICD-GGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE0","description":"ICD-OBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal contract stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59020","description":"Fetal contract stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oseltamivir phosphate 75mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9019","description":"Oseltamivir phosphate 75mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7195","description":"Factor ix recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC1","description":"ICD-OGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC1","description":"ICD-EGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD0","description":"ICD-KCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01933","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","description":"CPT-01933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB1","description":"ICD-BIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC146","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE0","description":"ICD-NGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC1","description":"ICD-GALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","description":"CPT-92639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"One-way allow prorated trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9604","description":"One-way allow prorated trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 5%_ 250 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9045","description":"Albumin (human)_ 5%_ 250 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE0","description":"ICD-HFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF1","description":"ICD-JCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA31","description":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0305","description":"HCPCS-B0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"EpiFix or Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4131","description":"EpiFix or Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE1","description":"ICD-CDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF1","description":"ICD-MLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41823","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us b & quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76510","description":"Ophth us b & quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE0","description":"ICD-JBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31720","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biodfence 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4140","description":"Biodfence 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC1","description":"ICD-HAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath report non routine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551F","description":"Cytopath report non routine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB1","description":"ICD-IHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE1","description":"ICD-HDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SkinTE_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4200","description":"SkinTE_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD0","description":"ICD-FALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part maxil lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5760","description":"Denture reln part maxil lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113A","description":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4405","description":"Nonpectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81201","description":"Apc gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE255","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC0","description":"ICD-DDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA1","description":"ICD-NDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME0","description":"ICD-IEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE1","description":"ICD-BIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip disart sach laminat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5600","description":"Hip disart sach laminat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE1","description":"ICD-AAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","description":"CPT-01320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","description":"HCPCS-J0169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF1","description":"ICD-LCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE0","description":"ICD-NIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD1","description":"ICD-IIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal smear for eosinophils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89190","description":"Nasal smear for eosinophils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx orbit w/o manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21400","description":"Closed tx orbit w/o manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE0","description":"ICD-NBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB1","description":"ICD-KEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cncr 0/ia melan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3321F","description":"Ajcc cncr 0/ia melan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA1","description":"ICD-IBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca screen;barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0106","description":"Colon ca screen;barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA1","description":"ICD-KFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA GIARDIA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87329","description":"IAAD IA GIARDIA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92992","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB0","description":"ICD-ABMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC0","description":"ICD-NHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay >=3sr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6603","description":"Cst hgh nble mtl inlay >=3sr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74160","description":"Ct abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cgh test developmental delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3870","description":"Cgh test developmental delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF1","description":"ICD-IILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26645","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB1","description":"ICD-OLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19330","description":"Removal of implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27075","description":"Resect hip tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antinuclear antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86038","description":"Antinuclear antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venous m-thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37188","description":"Venous m-thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF0","description":"ICD-IEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB56","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB1","description":"ICD-LDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE1","description":"ICD-KCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD0","description":"ICD-OCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74290","description":"Contrast x-ray gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB1","description":"ICD-AGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tooth transplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7272","description":"Tooth transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0129U","description":"Anesthesia for intracranial procedures; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96542","description":"Chemotherapy injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF1","description":"ICD-KGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD1","description":"ICD-JHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD1","description":"ICD-AFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder bone part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23130","description":"Remove shoulder bone part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA0","description":"ICD-HFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF0","description":"ICD-NILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (fiasp)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1812","description":"Insulin (fiasp)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB12","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE0","description":"ICD-OJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID1","description":"ICD-GFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD1","description":"ICD-LIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC1","description":"ICD-ACTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC1","description":"ICD-KIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB1","description":"ICD-HFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8001","description":"HCPCS-C8001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF0","description":"ICD-OHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE1","description":"ICD-KGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE1","description":"ICD-AFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC1","description":"ICD-EFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF1","description":"ICD-FFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA1","description":"ICD-FAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD1","description":"ICD-OIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF1","description":"ICD-JEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE1","description":"ICD-BHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4030F","description":"Oxygen therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC0","description":"ICD-CICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD0","description":"ICD-ODJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE1","description":"ICD-OGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icd counseling provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4470F","description":"Icd counseling provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF1","description":"ICD-NEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1024","description":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/strip short leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37718","description":"Ligate/strip short leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD0","description":"ICD-NBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96935","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE1","description":"ICD-KBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meperidine/promethazine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2180","description":"Meperidine/promethazine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cidofovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0740","description":"Cidofovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper arm/elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24999","description":"Upper arm/elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99381","description":"Init pm e/m new pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9163","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78430","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD1","description":"ICD-CCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB0","description":"ICD-JDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strattice tm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4130","description":"Strattice tm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37606","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0821T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symptoms improved/consist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1450F","description":"Symptoms improved/consist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult day care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5102","description":"Adult day care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB22","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD1","description":"ICD-FFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA1","description":"ICD-JDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC1","description":"ICD-HFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC0","description":"ICD-NIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE0","description":"ICD-JGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb <10g/dl_ med rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8975","description":"Hgb <10g/dl_ med rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE0","description":"ICD-CEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC30","description":"Medium Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA0","description":"ICD-JCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngography_ contrast_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70373","description":"Laryngography_ contrast_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1068T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1068T","description":"CPT-1068T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE0","description":"ICD-KHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE0","description":"ICD-CADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB0","description":"ICD-NELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID1","description":"ICD-AFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE0","description":"ICD-OBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD1","description":"ICD-EIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD1","description":"ICD-KIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33788","description":"Revision of pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24535","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34101","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD0","description":"ICD-GCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64610","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 6-35 mo im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90655","description":"Iiv3 vacc no prsv 6-35 mo im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB1","description":"ICD-CCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC1","description":"ICD-KGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water softening system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1625","description":"Water softening system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC0","description":"ICD-GFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB0","description":"ICD-JGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA11","description":"ICD-4LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE0","description":"ICD-JGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC0","description":"ICD-GHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD0","description":"ICD-NAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Podiatry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4028","description":"Podiatry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9380","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7165","description":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0049","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year reprod tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89344","description":"Storage/year reprod tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9291","description":"Not nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0574T","description":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2181","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB0","description":"ICD-GBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2290","description":"HCPCS-J2290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31552","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66985","description":"Insert lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91034","description":"Gastroesophageal reflux test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC1","description":"ICD-KFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA1","description":"ICD-GBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA1","description":"ICD-CBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC1","description":"ICD-KATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA0","description":"ICD-OIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB1","description":"ICD-MLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD1","description":"ICD-OGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro/pos wc cus>=22","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2625","description":"Adj skin pro/pos wc cus>=22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD1","description":"ICD-OLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99213","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD1","description":"ICD-KIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ guiding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1887","description":"Catheter_ guiding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF1","description":"ICD-KGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB1","description":"ICD-ADCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34001","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB1","description":"ICD-OKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD1","description":"ICD-OERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF0","description":"ICD-KDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC1","description":"ICD-CIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC0","description":"ICD-ADUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long qt synd gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81280","description":"Long qt synd gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8H","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC11","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ugt1a1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81350","description":"Ugt1a1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD0","description":"ICD-BEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","description":"HCPCS-M1376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD1","description":"ICD-KFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA1","description":"ICD-NJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove exostosis mandible","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21031","description":"Remove exostosis mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525F","description":"Initial visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9595","description":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC1","description":"ICD-BHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD1","description":"ICD-DEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA1","description":"ICD-JGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE1","description":"ICD-IDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD1","description":"ICD-EFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF0","description":"ICD-OJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sleep study attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95807","description":"Sleep study attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC0","description":"ICD-GCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA0","description":"ICD-GCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped critical care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99472","description":"Ped critical care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE1","description":"ICD-OERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1901","description":"HCPCS-A1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX22","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE254","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA214","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF1","description":"ICD-HGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD0","description":"ICD-LBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0083","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID1","description":"ICD-MAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2351","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pain neg no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8731","description":"Pain neg no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA0","description":"ICD-AFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3-d radiotherapy plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77295","description":"3-d radiotherapy plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt pt opt alterna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9059","description":"Onc prac mgmt pt opt alterna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA0","description":"ICD-CEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC0","description":"ICD-AGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA0","description":"ICD-ACAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67445","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC1","description":"ICD-KALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD0","description":"ICD-EEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0517U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","description":"CPT-0517U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0175","description":"Commode chair foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE1","description":"ICD-KCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE0","description":"ICD-BGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE0","description":"ICD-OAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dextran 40 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7100","description":"Dextran 40 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE0","description":"ICD-KHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE104","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r1/r2 no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9106","description":"Onc dx pancreatc p r1/r2 no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB1","description":"ICD-MJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA1","description":"ICD-KIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA0","description":"ICD-KAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24587","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD1","description":"ICD-PHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE1","description":"ICD-KANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amp reqd w/in 48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9641","description":"Amp reqd w/in 48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF0","description":"ICD-KBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4196","description":"PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Signs of melanoma absent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8749","description":"Signs of melanoma absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0520","description":"Management of new patient-caregiver dyad with dementia_ moderate complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iv oct for proc init vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291T","description":"Iv oct for proc init vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap vent/abd hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49652","description":"Lap vent/abd hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA0","description":"ICD-CGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC1","description":"ICD-IBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA0","description":"ICD-CHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC1","description":"ICD-IHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE0","description":"ICD-CFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB0","description":"ICD-MGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC1","description":"ICD-BIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove sling repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57287","description":"Revise/remove sling repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE0","description":"ICD-KGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB0","description":"ICD-NCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grp a strep test performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3210F","description":"Grp a strep test performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC0","description":"ICD-ODKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/>6.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2106","description":"Spherocylinder 4.00d/>6.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE0","description":"ICD-MEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA22","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB0","description":"ICD-JGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB0","description":"ICD-KFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE112","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63663","description":"Revise spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36589","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF0","description":"ICD-FHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71552","description":"MRI chest w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD1","description":"ICD-KICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA1","description":"ICD-PHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF0","description":"ICD-JCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD0","description":"ICD-CDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF0","description":"ICD-GDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD1","description":"ICD-DCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85385","description":"Fibrinogen antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF0","description":"ICD-CHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC1","description":"ICD-JEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE0","description":"ICD-PGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1301","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB1","description":"ICD-CAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD0","description":"ICD-GGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE1","description":"ICD-IHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA116","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99203","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF0","description":"ICD-OHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46080","description":"Incision of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66989","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE1","description":"ICD-EABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0105","description":"HCPCS-C0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","description":"HCPCS-L5827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0506","description":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE1","description":"ICD-KFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD1","description":"ICD-FHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Performance Met: Multimodal Pain Management Was Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2148","description":"Performance Met: Multimodal Pain Management Was Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-cov proc_ clinical trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0294","description":"Non-cov proc_ clinical trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA1","description":"ICD-AFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq&ic allg test drugs/biol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95018","description":"Perq&ic allg test drugs/biol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10mg (Darzalex)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9476","description":"Injection_ daratumumab_ 10mg (Darzalex)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle w/suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67334","description":"Revise eye muscle w/suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise additional leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27692","description":"Revise additional leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF1","description":"ICD-JFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto in fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88174","description":"Cytopath c/v auto in fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Camp overnite waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2036","description":"Camp overnite waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC0","description":"ICD-DDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE0","description":"ICD-HBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID1","description":"ICD-EEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg tech supp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93229","description":"Remote 30 day ecg tech supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA1","description":"ICD-OISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB211","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1456","description":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6610","description":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA1","description":"ICD-JBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis volume measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81050","description":"Urinalysis volume measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB1","description":"ICD-IFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC1","description":"ICD-GGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ref to outpt card rehab prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4500F","description":"Ref to outpt card rehab prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension sleeve lower ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2397","description":"Suspension sleeve lower ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD245","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC1","description":"ICD-FAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interstitial radiation source application; intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77777","description":"Interstitial radiation source application; intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF1","description":"ICD-GAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB0","description":"ICD-JGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9487","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE1","description":"ICD-FALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22614","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE1","description":"ICD-OCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9854","description":"Patient was not admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parkinsons disease mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8903","description":"Parkinsons disease mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF0","description":"ICD-MDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA0","description":"ICD-BEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27560","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5720","description":"Dentures rebase part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA0","description":"ICD-JAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304T","description":"Icar ischm mntrng sys device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA1","description":"ICD-CDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB1","description":"ICD-JHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30410","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33895","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC1","description":"ICD-NBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC1","description":"ICD-GHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF1","description":"ICD-ACMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61606","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; initial measurement and calibration of cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0662T","description":"Scalp cooling_ mechanical; initial measurement and calibration of cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part hand no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6020","description":"Part hand no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA1","description":"ICD-OGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal tissue processing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2785","description":"Corneal tissue processing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC1","description":"ICD-MBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB31","description":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB1","description":"ICD-GGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD0","description":"ICD-NEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0A","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD0","description":"ICD-KBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45562","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appropos mthd offloading rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4269F","description":"Appropos mthd offloading rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral appliance therapy (OAT) titration visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9955","description":"Oral appliance therapy (OAT) titration visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC0","description":"ICD-KIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interfyl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4171","description":"Interfyl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44208","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain fused base m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2751","description":"Crown porcelain fused base m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES350","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB0","description":"ICD-KAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1006F","description":"Osteoarthritis assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA0","description":"ICD-KDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","description":"HCPCS-M1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA51","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow harvest allogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38230","description":"Bone marrow harvest allogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE0","description":"ICD-FHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC1","description":"ICD-NCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay myeloperoxidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83876","description":"Assay myeloperoxidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA0","description":"ICD-FDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63173","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55705","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flex/ext wrist w/wo friction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6621","description":"Flex/ext wrist w/wo friction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF1","description":"ICD-NFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA11","description":"ICD-3CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0555","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","description":"HCPCS-G0555","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE0","description":"ICD-BDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB1","description":"ICD-KIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC1","description":"ICD-KCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD0","description":"ICD-OKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA0","description":"ICD-IAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF1","description":"ICD-OCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC1","description":"ICD-CBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus caus bac inx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9364","description":"Sinus caus bac inx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE0","description":"ICD-CBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA1","description":"ICD-EGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF1","description":"ICD-AGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE1","description":"ICD-GDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB1","description":"ICD-NBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC1","description":"ICD-KEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii type verify lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81371","description":"Hla i & ii type verify lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC1","description":"ICD-PDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE0","description":"ICD-GCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB1","description":"ICD-OADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB0","description":"ICD-FHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of chloramphenicol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82415","description":"Assay of chloramphenicol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28666","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD0","description":"ICD-KECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA25","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB1","description":"ICD-MHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ammonia test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4774","description":"Ammonia test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0504","description":"HCPCS-C0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist inter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46275","description":"Remove anal fist inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC1","description":"ICD-NIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF1","description":"ICD-OAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA1","description":"ICD-GEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1151","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1001","description":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA1","description":"ICD-PESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytherapy needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1715","description":"Brachytherapy needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC0","description":"ICD-KEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA1","description":"ICD-NGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA0","description":"ICD-KDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB0","description":"ICD-EHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24538","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9809","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61521","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE0","description":"ICD-BAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC1","description":"ICD-CDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE1","description":"ICD-KFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","description":"HCPCS-A2029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA1","description":"ICD-OJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD110","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE1","description":"ICD-BENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD1","description":"ICD-CICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0642U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0642U","description":"CPT-0642U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm system binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5282","description":"Ald fm/dm system binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7011","description":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82310","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD0","description":"ICD-IGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB1","description":"ICD-NHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73718","description":"MRI lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx cast molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2108","description":"Afo tib fx cast molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pleural cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32550","description":"Insert pleural cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0622","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatobiliary system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78226","description":"Hepatobiliary system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Puncture/clear windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31612","description":"Puncture/clear windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA1","description":"ICD-BHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC13","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86816","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8H","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5273","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imp neurosti pls gn any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8679","description":"Imp neurosti pls gn any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD1","description":"ICD-AACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57135","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA1","description":"ICD-OKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66983","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9056","description":"Blood_ l/r_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB1","description":"ICD-FGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE0","description":"ICD-OKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3470","description":"Hyaluronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA1","description":"ICD-KCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef complet w/intact nutrient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4150","description":"Ef complet w/intact nutrient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB1","description":"ICD-NKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE0","description":"ICD-EBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF0","description":"ICD-FCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD0","description":"ICD-CECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA1","description":"ICD-KBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PEANUT ALLG ASMT EPI CLIN RX","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178U","description":"PEANUT ALLG ASMT EPI CLIN RX","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE1","description":"ICD-KEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC0","description":"ICD-GGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC0","description":"ICD-FGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD0","description":"ICD-PLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior swing band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2335","description":"Anterior swing band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB1","description":"ICD-FAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD126","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB1","description":"ICD-NEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31624","description":"Dx bronchoscope/lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF1","description":"ICD-CCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE0","description":"ICD-FCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA1","description":"ICD-CGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC0","description":"ICD-BEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Next gen aco model<10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9868","description":"Next gen aco model<10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3761F","description":"Pt w/o dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA1","description":"ICD-OHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9987","description":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF1","description":"ICD-BDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6246","description":"Hydrogel drg >16<=48 in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF1","description":"ICD-ODFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB0","description":"ICD-GFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA0","description":"ICD-OLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2101","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA1","description":"ICD-KDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Death occurring after discharge from the hospital but within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9816","description":"Death occurring after discharge from the hospital but within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So 8 ab rstr can/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3660","description":"So 8 ab rstr can/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF0","description":"ICD-NDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX53","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42950","description":"Reconstruction of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59151","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC21","description":"ICD-4AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk thigh lacer glut/ischia m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5682","description":"Bk thigh lacer glut/ischia m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial complete study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93886","description":"Intracranial complete study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE0","description":"ICD-EIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neomatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2021","description":"Neomatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB0","description":"ICD-DCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB1","description":"ICD-JDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE1","description":"ICD-NCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stimulants synthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80371","description":"Stimulants synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC0","description":"ICD-AILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC35","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guided tissue regeneration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3432","description":"Guided tissue regeneration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB0","description":"ICD-GDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF1","description":"ICD-KCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF1","description":"ICD-JDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time lee & white","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85345","description":"Coagulation time lee & white","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt disagree w/gui","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9058","description":"Onc prac mgmt disagree w/gui","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB0","description":"ICD-GBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF1","description":"ICD-GDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE0","description":"ICD-KBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0477","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68400","description":"Incise/drain tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE0","description":"ICD-MFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB0","description":"ICD-KIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD0","description":"ICD-NDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC0","description":"ICD-GANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD1","description":"ICD-HFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00530","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","description":"CPT-00530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External bleaching home app","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9975","description":"External bleaching home app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB0","description":"ICD-FFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70300","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE0","description":"ICD-ODSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0067U","description":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27705","description":"Incision of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE0","description":"ICD-KFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0741","description":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92004","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA0","description":"ICD-CEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21050","description":"Removal of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF0","description":"ICD-NKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood sulfhemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83060","description":"Blood sulfhemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiometry threshold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210T","description":"Speech audiometry threshold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD1","description":"ICD-OJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC1","description":"ICD-FEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77399","description":"External radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE1","description":"ICD-LFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC1","description":"ICD-OKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA1","description":"ICD-MHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED0","description":"ICD-MLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF0","description":"ICD-KEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF1","description":"ICD-CCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE0","description":"ICD-OLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mitoxantrone hydrochl / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9293","description":"Mitoxantrone hydrochl / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0680","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","description":"HCPCS-G0680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC1","description":"ICD-ODRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE1","description":"ICD-AIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","description":"HCPCS-G0562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF1","description":"ICD-LDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chiropractic manj 5 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98942","description":"Chiropractic manj 5 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID0","description":"ICD-BCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0104","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0104","description":"CDT-D0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94051","description":"Anesth vaginal procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visualization of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31615","description":"Visualization of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; initial device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0648","description":"Lso sag r an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92652","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC11","description":"ICD-1LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD0","description":"ICD-NCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test spin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86920","description":"Compatibility test spin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD0","description":"ICD-CHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB1","description":"ICD-CEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt dischg >2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9254","description":"Doc pt dischg >2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC0","description":"ICD-JCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD1","description":"ICD-ADDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC1","description":"ICD-FECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA1","description":"ICD-NLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE0","description":"ICD-MFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA1","description":"ICD-BCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27445","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA0","description":"ICD-GCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX17","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one well-child visit with PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9965","description":"Patient did not receive at least one well-child visit with PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC1","description":"ICD-CHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17264","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25605","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB121","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat/back cus no dmepdac ver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0669","description":"Seat/back cus no dmepdac ver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME0","description":"ICD-NLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy fundoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43280","description":"Laparoscopy fundoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB220","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92541","description":"Spontaneous nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA1","description":"ICD-JANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA0","description":"ICD-GAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for tear sac x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68850","description":"Injection for tear sac x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Access thoracic lymph duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38794","description":"Access thoracic lymph duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bowel surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44899","description":"Bowel surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11301","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB0","description":"ICD-HGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7008","description":"Pediatric electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0544U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544U","description":"CPT-0544U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF0","description":"ICD-NDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8045","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC31","description":"ICD-3CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7038","description":"Pos airway pressure filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB1","description":"ICD-OGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap paraesoph her rpr w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43282","description":"Lap paraesoph her rpr w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA0","description":"ICD-LIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC11","description":"ICD-1CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID1","description":"ICD-GAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA31","description":"ICD-2DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE0","description":"ICD-JBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjst forearm pro/sup device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1802","description":"Adjst forearm pro/sup device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC235","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aneurysm pressure sens study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93982","description":"Aneurysm pressure sens study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2115","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC0","description":"ICD-GHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB0","description":"ICD-BCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC0","description":"ICD-FCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD0","description":"ICD-NBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1441","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","description":"HCPCS-M1441","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles bifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92341","description":"Fit spectacles bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","description":"HCPCS-Q4411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA0","description":"ICD-KIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90471","description":"Immunization admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29877","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA1","description":"ICD-JEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE1","description":"ICD-DCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36575","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC104","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA31","description":"ICD-1DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB1","description":"ICD-FAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML15","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop image confirm excise","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8872","description":"Intraop image confirm excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB0","description":"ICD-MADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB0","description":"ICD-NFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB1","description":"ICD-OCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58700","description":"Removal of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED0","description":"ICD-ECED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC0","description":"ICD-DIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX22","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25125","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC1","description":"ICD-KCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12052","description":"Intmd rpr face/mm 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54385","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC55","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE0","description":"ICD-OFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10004","description":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF1","description":"ICD-ICTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA0","description":"ICD-KDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD1","description":"ICD-OJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB0","description":"ICD-IGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA1","description":"ICD-FGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood clot lysis time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85175","description":"Blood clot lysis time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3424","description":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6025","description":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC1","description":"ICD-FDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Statin med pres at disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8816","description":"Statin med pres at disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA1","description":"ICD-NINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA11","description":"ICD-3KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54861","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC0","description":"ICD-CGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise sacral spine tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49215","description":"Excise sacral spine tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF0","description":"ICD-KCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26455","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE0","description":"ICD-CIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr-staph dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87641","description":"Mr-staph dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2779","description":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy not used_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1057","description":"Aspirin or another antiplatelet therapy not used_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF0","description":"ICD-MCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7615","description":"Levalbuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radical resection of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24149","description":"Radical resection of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD1","description":"ICD-NJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m oxidronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9561","description":"Tc99m oxidronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB1","description":"ICD-JBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC1","description":"ICD-IAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respirator motion mgmt simul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77293","description":"Respirator motion mgmt simul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB1","description":"ICD-BCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD1","description":"ICD-BBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19284","description":"Perq dev breast add strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF1","description":"ICD-ODJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD1","description":"ICD-GFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain 2 piece system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4426","description":"Ost pch drain 2 piece system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin electrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83020","description":"Hemoglobin electrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE1","description":"ICD-JCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Keroxx (2.5 g/cc)_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4202","description":"Keroxx (2.5 g/cc)_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF1","description":"ICD-NAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD1","description":"ICD-GITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC1","description":"ICD-MGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF0","description":"ICD-JHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD1","description":"ICD-MCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0957T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","description":"CPT-0957T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not calculated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8421","description":"Bmi not calculated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD0","description":"ICD-HERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX23","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB0","description":"ICD-NCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF1","description":"ICD-FGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC1","description":"ICD-BICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91314","description":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD0","description":"ICD-GHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2B","description":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF0","description":"ICD-GABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA0","description":"ICD-CCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ligate spermatic vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55550","description":"Laparo ligate spermatic vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB1","description":"ICD-FIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD0","description":"ICD-NFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace lithium battery 1.5v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4602","description":"Replace lithium battery 1.5v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC1","description":"ICD-IIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB214","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD0","description":"ICD-HARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal ak ultra-light m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5790","description":"Exoskeletal ak ultra-light m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF0","description":"ICD-KIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35331","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25265","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup body cast plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4001","description":"Cast sup body cast plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68135","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF1","description":"ICD-CGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE1","description":"ICD-NGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF1","description":"ICD-MKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines 13 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80347","description":"Benzodiazepines 13 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF0","description":"ICD-CDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inhalation solution for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7699","description":"Inhalation solution for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE1","description":"ICD-FGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Porfimer sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9600","description":"Porfimer sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA0","description":"ICD-FFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE0","description":"ICD-GCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC0","description":"ICD-CBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF1","description":"ICD-GCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA1","description":"ICD-OHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF0","description":"ICD-BFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4044","description":"Cast sup lng leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla x-math non-cytotoxic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86825","description":"Hla x-math non-cytotoxic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE225","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90937","description":"Hemodialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59612","description":"Vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA1","description":"ICD-OBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE1","description":"ICD-OJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE1","description":"ICD-GCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA0","description":"ICD-BGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procure donor sperm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4026","description":"Procure donor sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB0","description":"ICD-FGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB0","description":"ICD-CFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA0","description":"ICD-LCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD104","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Consultation with family","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90887","description":"Consultation with family","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3918","description":"Metacarp fx orthosis pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC0","description":"ICD-OIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD1","description":"ICD-GEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA0","description":"ICD-OAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gel pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0196","description":"Gel pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breath test heart reject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085T","description":"Breath test heart reject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES217","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62325","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB0","description":"ICD-OJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rv1 vacc 2 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90681","description":"Rv1 vacc 2 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte immune globulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7504","description":"Lymphocyte immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL26","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD0","description":"ICD-PDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 3 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95863","description":"Muscle test 3 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB0","description":"ICD-GAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78708","description":"K flow/funct image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94626","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral mr contrast_ 100 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9954","description":"Oral mr contrast_ 100 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA1","description":"ICD-MCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE1","description":"ICD-IEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15004","description":"Wound prep f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD0","description":"ICD-GFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim not spine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0747","description":"Elec osteogen stim not spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cultured chondrocytes implnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7330","description":"Cultured chondrocytes implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53605","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9859","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE0","description":"ICD-GFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF0","description":"ICD-LAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99385","description":"Prev visit new age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Final refract +/- 1.0 in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9519","description":"Final refract +/- 1.0 in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49451","description":"Replace duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB1","description":"ICD-GGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC0","description":"ICD-KDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tone decay hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92563","description":"Tone decay hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134A","description":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28665","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE0","description":"ICD-PASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE1","description":"ICD-DDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Azathioprine oral 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7500","description":"Azathioprine oral 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Matristem wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4119","description":"Matristem wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB1","description":"ICD-MIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-first 30 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9220","description":"Deep sedation/general anesthesia-first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD0","description":"ICD-GAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pelvic structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51597","description":"Removal of pelvic structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22212","description":"Incis 1 vertebral seg thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1207","description":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 5 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP05","description":"Auto.test pane pricing code_ 5 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE245","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0823","description":"Pwc gp 2 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB0","description":"ICD-GITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC1","description":"ICD-OJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE1","description":"ICD-KDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB1","description":"ICD-ACBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5136","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","description":"HCPCS-Q5136","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA1","description":"ICD-IHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB255","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compression bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8431","description":"Compression bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD1","description":"ICD-GDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cogenex Flowable Amnion_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4230","description":"Cogenex Flowable Amnion_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF0","description":"ICD-FHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC1","description":"ICD-JBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1628","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142U","description":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD255","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF1","description":"ICD-NJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lab labial veneer resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2961","description":"Lab labial veneer resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD1","description":"ICD-JBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX43","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0986T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","description":"CPT-0986T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF0","description":"ICD-OLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27198","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD0","description":"ICD-OBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME1","description":"ICD-AEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE0","description":"ICD-JEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP NEXT GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222U","description":"RHD&RHCE GNTYP NEXT GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Via matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4309","description":"Via matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF1","description":"ICD-BECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80204","description":"Methotrexate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA0","description":"ICD-IBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA0","description":"ICD-JCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF0","description":"ICD-OABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID0","description":"ICD-NAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent placemt retro carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37217","description":"Stent placemt retro carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9306","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9306","description":"HCPCS-C9306","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE151","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC0","description":"ICD-NJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE1","description":"ICD-FCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ partial arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9946","description":"Occlusal guard - hard appliance_ partial arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit picc insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5520","description":"Hit picc insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","description":"CPT-01634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC1","description":"ICD-BGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF1","description":"ICD-GIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF0","description":"ICD-FEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Variable asphericity lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2499","description":"Variable asphericity lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8H","description":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0624U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","description":"CPT-0624U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472T","description":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain to peritoneal cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49062","description":"Drain to peritoneal cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC1","description":"ICD-GFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD0","description":"ICD-NBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD0","description":"ICD-OFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC0","description":"ICD-ECHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA1","description":"ICD-CDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr cbl elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0492","description":"Emr pwr cbl elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9917","description":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Youth size brief/diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4533","description":"Youth size brief/diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME0","description":"ICD-OFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC1","description":"ICD-MFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sacral nerve stim test lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4290","description":"Sacral nerve stim test lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29874","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermatological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96999","description":"Dermatological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE0","description":"ICD-NICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0670T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA0","description":"ICD-OBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA1","description":"ICD-JCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain blood from under nail","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11740","description":"Drain blood from under nail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD1","description":"ICD-BHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80362","description":"Opioids & opiate analogs 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB0","description":"ICD-MFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF0","description":"ICD-NIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01961","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","description":"CPT-01961","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB1","description":"ICD-BFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c ab test confirm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86804","description":"Hep c ab test confirm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC0","description":"ICD-DAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA22","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034U","description":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF1","description":"ICD-PKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decalcify tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88311","description":"Decalcify tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2115","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1801","description":"CDT-D1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0505","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0505","description":"CDT-D0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC1","description":"ICD-BDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7513","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB1","description":"ICD-HIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4238","description":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA1","description":"ICD-CEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA1","description":"ICD-CCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA06","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB0","description":"ICD-OGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00731","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","description":"CPT-00731","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xe133 xenon 10mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9558","description":"Xe133 xenon 10mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8D","description":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF1","description":"ICD-OJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray stress view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77071","description":"X-ray stress view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange amplify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81340","description":"Trb@ gene rearrange amplify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27295","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert heyman uteri capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58346","description":"Insert heyman uteri capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair commode seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0968","description":"Wheelchair commode seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen sngl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33212","description":"Insert pulse gen sngl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8I","description":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268T","description":"Implt/rpl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC1","description":"ICD-OIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26765","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD1","description":"ICD-FETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:1)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1728","description":"Employment - Employment Skills Development (1:1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME1","description":"ICD-NFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB0","description":"ICD-CIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair anal fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46288","description":"Repair anal fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditor evoke potent compre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92585","description":"Auditor evoke potent compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pad water circulating heat u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0249","description":"Pad water circulating heat u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58805","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB0","description":"ICD-AIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0515U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","description":"CPT-0515U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Death did not occur during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9815","description":"Death did not occur during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4296","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","description":"HCPCS-A4296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC0","description":"ICD-ADBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27472","description":"Repair/graft of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE1","description":"ICD-NJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB1","description":"ICD-KEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD1","description":"ICD-FBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB160","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF0","description":"ICD-IAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE0","description":"ICD-MLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9842","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF0","description":"ICD-HFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF0","description":"ICD-LBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA1","description":"ICD-NCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA1","description":"ICD-FADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB0","description":"ICD-KGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC1","description":"ICD-FBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE0","description":"ICD-OAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40654","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF1","description":"ICD-GHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE0","description":"ICD-OLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telavancin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3095","description":"Telavancin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA0","description":"ICD-PJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB1","description":"ICD-NBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC1","description":"ICD-DDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB0","description":"ICD-GHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB1","description":"ICD-HEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF1","description":"ICD-FAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC0","description":"ICD-GHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42420","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF1","description":"ICD-KEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenervation anal musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46505","description":"Chemodenervation anal musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00218","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","description":"CPT-00218","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC21","description":"ICD-2BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE0","description":"ICD-EDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF0","description":"ICD-ABLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF1","description":"ICD-JIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5820","description":"Denture interm part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC0","description":"ICD-JFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2A","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0550","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","description":"HCPCS-G0550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF0","description":"ICD-EBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE0","description":"ICD-ADIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD0","description":"ICD-CFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME0","description":"ICD-AIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB0","description":"ICD-NEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elec w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0266","description":"Hosp bed total elec w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gjb2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81252","description":"Gjb2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37285","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","description":"CPT-37285","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD0","description":"ICD-NEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1035","description":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF1","description":"ICD-EILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl push transfuse 2 yr/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36440","description":"Bl push transfuse 2 yr/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA0","description":"ICD-JHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD1","description":"ICD-NJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD0","description":"ICD-BCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"OPH AMD ALYS 3 GENE VARIANTS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205U","description":"OPH AMD ALYS 3 GENE VARIANTS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC0","description":"ICD-DCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF1","description":"ICD-EAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC1","description":"ICD-BIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB11","description":"ICD-2KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF1","description":"ICD-KCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86805","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE1","description":"ICD-ACUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB0","description":"ICD-HDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin most rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5551","description":"Insulin most rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ekg for initial prevent exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0403","description":"Ekg for initial prevent exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED1","description":"ICD-OBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital outpt clinic visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0463","description":"Hospital outpt clinic visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA13","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No transfercare chklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584F","description":"No transfercare chklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF0","description":"ICD-KGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Annual nursing fac assessmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99318","description":"Annual nursing fac assessmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36909","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED1","description":"ICD-EDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC1","description":"ICD-PGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE1","description":"ICD-OEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC0","description":"ICD-ODCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF1","description":"ICD-CBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC1","description":"ICD-BHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not recvng antiv hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4151F","description":"Pt not recvng antiv hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1074T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1074T","description":"CPT-1074T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief emotional/behav assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96127","description":"Brief emotional/behav assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2065","description":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC1","description":"ICD-GAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE1","description":"ICD-GIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF0","description":"ICD-GDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA1","description":"ICD-DIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meniscal trnspl knee w/scpe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29868","description":"Meniscal trnspl knee w/scpe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD0","description":"ICD-NGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA1","description":"ICD-AEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88167","description":"Cytopath tbs c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt gest hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9211","description":"Home mgmt gest hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC1","description":"ICD-BAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD0","description":"ICD-PKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD1","description":"ICD-FCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","description":"CPT-15018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF0","description":"ICD-PISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA0","description":"ICD-FBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE0","description":"ICD-BCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF0","description":"ICD-CBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD0","description":"ICD-HIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA25","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF1","description":"ICD-GDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE0","description":"ICD-OGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg <= 16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6245","description":"Hydrogel drg <= 16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath xtrnl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36227","description":"Place cath xtrnl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF0","description":"ICD-IGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA1","description":"ICD-AHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC1","description":"ICD-NDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md doc_ door to punc tm >2hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9581","description":"Md doc_ door to punc tm >2hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE0","description":"ICD-CIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8G","description":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB1","description":"ICD-NDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80179","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF0","description":"ICD-EEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6111","description":"Implnt/abut remov dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9032","description":"Platelets_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB0","description":"ICD-NLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isch containmt/narrow m-l so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5649","description":"Isch containmt/narrow m-l so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA0","description":"ICD-MDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20525","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia- first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9239","description":"intravenous moderate (conscious) sedation/analgesia- first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC1","description":"ICD-CHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF1","description":"ICD-JGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA1","description":"ICD-KAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE0","description":"ICD-OKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB0","description":"ICD-BADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0013","description":"Custom power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA1","description":"ICD-CFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB0","description":"ICD-GIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF1","description":"ICD-OIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA1","description":"ICD-KCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision addl breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19126","description":"Excision addl breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF0","description":"ICD-ACUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9901","description":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC0","description":"ICD-ODVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures complete maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5110","description":"Dentures complete maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE0","description":"ICD-OEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3399","description":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50951","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens polycarb or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2784","description":"Lens polycarb or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0722T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB134","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB1","description":"ICD-FCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC0","description":"ICD-DCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak 4 bar ling w/hydraul swig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5613","description":"Ak 4 bar ling w/hydraul swig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr hern preemie reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49491","description":"Rpr hern preemie reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7d/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2207","description":"Lens sphcy bifocal 4.25-7d/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC0","description":"ICD-LHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transdermal gfr measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0602T","description":"Transdermal gfr measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB1","description":"ICD-HDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/ fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21339","description":"Open nasoethmoid fx w/ fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA1","description":"ICD-ACTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1004","description":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB1","description":"ICD-OGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9742","description":"Laryngoscopy with injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC0","description":"ICD-BFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262U","description":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB0","description":"ICD-ADDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC0","description":"ICD-GECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capture limited","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0380","description":"Cone beam ct capture limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trtmnt simulation 3d image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0393","description":"Trtmnt simulation 3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0017","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB0","description":"ICD-DAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA0","description":"ICD-JBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE1","description":"ICD-LCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","description":"CPT-01842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME1","description":"ICD-EEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2209","description":"Lens sphcy bifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc abdl tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22900","description":"Exc abdl tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA0","description":"ICD-IETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11423","description":"Exc h-f-nk-sp b9+marg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj pembrolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9271","description":"Inj pembrolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE1","description":"ICD-NETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC0","description":"ICD-JGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA1","description":"ICD-JBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF1","description":"ICD-FAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis glass test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81020","description":"Urinalysis glass test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electro-oculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92270","description":"Electro-oculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair brain fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62100","description":"Repair brain fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4490","description":"Above knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7045","description":"Pediatric electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lovotibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3394","description":"Injection_ lovotibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB1","description":"ICD-MIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4148","description":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77022","description":"MRI for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7320","description":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD0","description":"ICD-NKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54340","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70471","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","description":"CPT-70471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF1","description":"ICD-BCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9596","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB1","description":"ICD-MECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA1","description":"ICD-BDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62143","description":"Replace skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD0","description":"ICD-OIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA0","description":"ICD-CFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15774","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA0","description":"ICD-DHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA130","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81406","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC0","description":"ICD-FDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaccina ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90393","description":"Vaccina ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND1","description":"ICD-NEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dis site tele svcs RHC/FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2025","description":"Dis site tele svcs RHC/FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34715","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj trigeminal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64400","description":"N block inj trigeminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC1","description":"ICD-CBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF0","description":"ICD-MGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE1","description":"ICD-NHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF1","description":"ICD-IAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB1","description":"ICD-OAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB1","description":"ICD-OCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA22","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c vent tray fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1029","description":"W/c vent tray fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Filter gone aft 3mos placmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9541","description":"Filter gone aft 3mos placmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD0","description":"ICD-JEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD0","description":"ICD-CIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF1","description":"ICD-KEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF0","description":"ICD-OILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA1","description":"ICD-DAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB0","description":"ICD-MCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC1","description":"ICD-GEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA0","description":"ICD-ACCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58563","description":"Hysteroscopy ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87487","description":"Chylmd pneum dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB0","description":"ICD-IADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA0","description":"ICD-ACLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound exam aaa screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0389","description":"Ultrasound exam aaa screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF0","description":"ICD-BHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB1","description":"ICD-OHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx distal radial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25606","description":"Treat fx distal radial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF1","description":"ICD-BCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","description":"CPT-00404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA0","description":"ICD-HFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA1","description":"ICD-AEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA1","description":"ICD-KGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA1","description":"ICD-CBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB0","description":"ICD-HDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28118","description":"Removal of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB1","description":"ICD-HCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD1","description":"ICD-BIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC0","description":"ICD-NCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA1","description":"ICD-CCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD0","description":"ICD-NIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB1","description":"ICD-PCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC1","description":"ICD-OEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1748","description":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen drsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6022","description":"Collagen drsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF0","description":"ICD-MBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB1","description":"ICD-KBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diag tst detect mucos abnorm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0431","description":"Diag tst detect mucos abnorm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0102","description":"HCPCS-A0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7402","description":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9044","description":"Injection_ cemiplimab-rwlc_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient died at any time during the 24-month measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9751","description":"Patient died at any time during the 24-month measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exposure behavior treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373T","description":"Exposure behavior treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37605","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0749T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC0","description":"ICD-OIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6021","description":"Collagen dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA0","description":"ICD-JCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB1","description":"ICD-FHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD221","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft liner for complete or partial removable denture - indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5765","description":"Soft liner for complete or partial removable denture - indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61020","description":"Remove brain cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultraviolet light therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96900","description":"Ultraviolet light therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF0","description":"ICD-BFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Potent antivir thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4276F","description":"Potent antivir thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA0","description":"ICD-OKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC1","description":"ICD-BABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 tositumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9545","description":"I131 tositumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC0","description":"ICD-MBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND0","description":"ICD-JFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc of dsm-iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9213","description":"No doc of dsm-iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB1","description":"ICD-GDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE1","description":"ICD-EDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB0","description":"ICD-FHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA1","description":"ICD-PKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6553","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE0","description":"ICD-EABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX51","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD1","description":"ICD-FGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pessary_ non rubber_any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4562","description":"Pessary_ non rubber_any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radxps in end rprt4fluro pxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6045F","description":"Radxps in end rprt4fluro pxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skeletal muscle relaxant 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80369","description":"Skeletal muscle relaxant 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB0","description":"ICD-JIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF0","description":"ICD-KFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0285","description":"Amphotericin b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physician standby services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99360","description":"Physician standby services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care coord at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9477","description":"Care coord at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071A","description":"ADM SARSCV2 10MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl bleaching per arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9972","description":"Extrnl bleaching per arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE0","description":"ICD-NCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB0","description":"ICD-PFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6700","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","description":"HCPCS-L6700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol wipes per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4245","description":"Alcohol wipes per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD231","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF0","description":"ICD-CFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE1","description":"ICD-BAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86231","description":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44340","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE0","description":"ICD-OLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9326","description":"Hit cont pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening performed and positive and provision of recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9919","description":"Screening performed and positive and provision of recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ single_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1786","description":"Pmkr_ single_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE0","description":"ICD-GHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9227","description":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB0","description":"ICD-MHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA0","description":"ICD-CDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC0","description":"ICD-NBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay bld/serum cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82465","description":"Assay bld/serum cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE1","description":"ICD-JAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74010","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71271","description":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF1","description":"ICD-FACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC1","description":"ICD-BGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt maxil ch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5730","description":"Denture reln cmplt maxil ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral prescription drug chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8999","description":"Oral prescription drug chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26485","description":"Transplant palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA0","description":"ICD-MCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7637","description":"Dexamethasone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65426","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC1","description":"ICD-LARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nonunion hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26546","description":"Repair nonunion hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD0","description":"ICD-PHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pm generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33233","description":"Removal of pm generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig geno no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8458","description":"Pt inelig geno no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE0","description":"ICD-JBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of gland abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56420","description":"Drainage of gland abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ low-pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4088","description":"Gastro/jejuno tube_ low-pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recd scrn hcv infec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9383","description":"Recd scrn hcv infec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dsg<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6231","description":"Hydrogel dsg<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF0","description":"ICD-CIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB26","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE1","description":"ICD-CDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88360","description":"Tumor immunohistochem/manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84432","description":"Assay of thyroglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE215","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA1","description":"ICD-MCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE1","description":"ICD-FBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC1","description":"ICD-ACIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF0","description":"ICD-FHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77431","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remov/replc ur sphinctr comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53448","description":"Remov/replc ur sphinctr comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supported employment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6106","description":"Supported employment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33015","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF1","description":"ICD-OKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitatereducedplasma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9044","description":"Cryoprecipitatereducedplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB1","description":"ICD-GIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So acro/clav can web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3670","description":"So acro/clav can web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Any patients who had no asthma controller medications dispensed during the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9808","description":"Any patients who had no asthma controller medications dispensed during the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE0","description":"ICD-DCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8040","description":"Limited dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD1","description":"ICD-EBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motor &/ sens nrve cndj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95905","description":"Motor &/ sens nrve cndj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16025","description":"Dress/debrid p-thick burn m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD0","description":"ICD-BFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB1","description":"ICD-ADEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"L/s ratio fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83661","description":"L/s ratio fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0222","description":"Injection_ Patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin dispos pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5571","description":"Insulin dispos pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ranibizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2778","description":"Ranibizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF1","description":"ICD-CFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0494T","description":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND1","description":"ICD-ODND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE1","description":"ICD-GHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lith ion batt cid_non-earlvl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8623","description":"Lith ion batt cid_non-earlvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC32","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB110","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD1","description":"ICD-NJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c vent tray gimbaled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1030","description":"W/c vent tray gimbaled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF0","description":"ICD-GIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA0","description":"ICD-OJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4012F","description":"Warfarin therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26474","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD1","description":"ICD-DDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34711","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC0","description":"ICD-BGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i/ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86829","description":"Hla class i/ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD0","description":"ICD-GIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC1","description":"ICD-KGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA1","description":"ICD-NLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolysins screen i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85390","description":"Fibrinolysins screen i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE1","description":"ICD-FENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","description":"HCPCS-E1032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC36","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE0","description":"ICD-BEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disk/foam pad +or- adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5126","description":"Disk/foam pad +or- adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brake for wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0159","description":"Brake for wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays transcath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75894","description":"X-rays transcath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB11","description":"ICD-3CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE205","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC1","description":"ICD-GIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33824","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemical cauterization of granulation tissue (ie_ proud flesh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17250","description":"Chemical cauterization of granulation tissue (ie_ proud flesh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA0","description":"ICD-KDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB0","description":"ICD-BIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE1","description":"ICD-CDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fluoride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82735","description":"Assay of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE0","description":"ICD-LFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant mandible for augment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7996","description":"Implant mandible for augment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC0","description":"ICD-ODJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC1","description":"ICD-CHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC1","description":"ICD-JBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF1","description":"ICD-FBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3360","description":"Diazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD211","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31576","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF0","description":"ICD-GCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC0","description":"ICD-NEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA0","description":"ICD-FGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB31","description":"ICD-4LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD0","description":"ICD-MEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88140","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC0","description":"ICD-NBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home environment assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1028","description":"Home environment assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF0","description":"ICD-IHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0204","description":"HCPCS-C0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF0","description":"ICD-OLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD1","description":"ICD-OHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB1","description":"ICD-OAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8F","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA0","description":"ICD-CIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA0","description":"ICD-BCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB0","description":"ICD-KEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA1","description":"ICD-JGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43340","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso r fram soft pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0467","description":"Tlso r fram soft pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2403","description":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA1","description":"ICD-KDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA1","description":"ICD-NABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA0","description":"ICD-GFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC0","description":"ICD-PGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB1","description":"ICD-BCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33781","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7197","description":"Antithrombin iii injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD0","description":"ICD-BHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA1","description":"ICD-CEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD1","description":"ICD-AGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA0","description":"ICD-MADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD1","description":"ICD-BCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1304","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD0","description":"ICD-KAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA0","description":"ICD-EIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE1","description":"ICD-KABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01965","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","description":"CPT-01965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF1","description":"ICD-KFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA0","description":"ICD-IFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aoe comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9466","description":"Aoe comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD1","description":"ICD-IBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD0","description":"ICD-KHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Program intake assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1023","description":"Program intake assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC0","description":"ICD-FFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF1","description":"ICD-OHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC1","description":"ICD-KGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brca1&2 185&5385&6174 var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81212","description":"Brca1&2 185&5385&6174 var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27524","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit pain imp pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9328","description":"Hit pain imp pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pcv13 vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90670","description":"Pcv13 vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC0","description":"ICD-FHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF1","description":"ICD-CITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Humidif extens supple w ippb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0550","description":"Humidif extens supple w ippb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76000","description":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD1","description":"ICD-NCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB13","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC0","description":"ICD-NEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA01","description":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/insert implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65103","description":"Remove eye/insert implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excis uppr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21049","description":"Excis uppr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF1","description":"ICD-JDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE1","description":"ICD-CHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87510","description":"Gardner vag dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2108","description":"Spherocylinder 4.25d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB1","description":"ICD-KESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA0","description":"ICD-JIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB1","description":"ICD-KFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0C","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2020","description":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier for use w/ regula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0555","description":"Humidifier for use w/ regula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retinal prosth int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1841","description":"Retinal prosth int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD0","description":"ICD-NDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD0","description":"ICD-CDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME1","description":"ICD-MIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB1","description":"ICD-HARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ibutilide fumarate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1742","description":"Ibutilide fumarate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC1","description":"ICD-OAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF0","description":"ICD-ADAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE1","description":"ICD-KAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB1","description":"ICD-KHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4340","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","description":"HCPCS-Q4340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25530","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brompheniramine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0945","description":"Brompheniramine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27392","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9160","description":"Lang comp goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9351","description":"Topotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD0","description":"ICD-MAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conditioning play audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92582","description":"Conditioning play audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF0","description":"ICD-BGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relocation pocket pacemaker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33222","description":"Relocation pocket pacemaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC1","description":"ICD-CAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0090","description":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I&d abscess extraoral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7520","description":"I&d abscess extraoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF0","description":"ICD-BIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_non-prog_ perm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1891","description":"Infusion pump_non-prog_ perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB1","description":"ICD-NBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ pasireotide long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2502","description":"Inj_ pasireotide long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB10","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0806","description":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1034T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1034T","description":"CPT-1034T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99328","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart image (pet) single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78491","description":"Heart image (pet) single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health risk assessment test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99420","description":"Health risk assessment test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED1","description":"ICD-AHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9144","description":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB0","description":"ICD-OLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED0","description":"ICD-MIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC0","description":"ICD-EIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE0","description":"ICD-OLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ekg tracing for initial prev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0404","description":"Ekg tracing for initial prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE1","description":"ICD-CGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump optical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0477","description":"Drug test presump optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC116","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Standing frame sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0638","description":"Standing frame sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16<=48 sq in watr/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6229","description":"Gauze >16<=48 sq in watr/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen amphetamines 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80324","description":"Drug screen amphetamines 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA1","description":"ICD-FFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA0","description":"ICD-KEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME0","description":"ICD-JHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD0","description":"ICD-NLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE0","description":"ICD-OJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF1","description":"ICD-BETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF1","description":"ICD-CACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diuretic thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4221F","description":"Diuretic thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whole body photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96904","description":"Whole body photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0818T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose fx w/skele fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21330","description":"Open tx nose fx w/skele fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4452","description":"Waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82131","description":"Amino acids single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt education noc individ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9445","description":"Pt education noc individ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND1","description":"ICD-KAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB1","description":"ICD-GCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC15","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracran angioplsty w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61635","description":"Intracran angioplsty w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lysis penil circumic lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54162","description":"Lysis penil circumic lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26542","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID1","description":"ICD-FAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply r&l pulm art bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33620","description":"Apply r&l pulm art bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA1","description":"ICD-KCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11312","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE1","description":"ICD-OLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0537T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0773T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA1","description":"ICD-NEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair calf rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0995","description":"Wheelchair calf rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA1","description":"ICD-OKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED0","description":"ICD-EBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23500","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lithium ion battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7368","description":"Lithium ion battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA1","description":"ICD-BBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins vag brachytx device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57156","description":"Ins vag brachytx device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC0","description":"ICD-NFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC0","description":"ICD-NKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB0","description":"ICD-OGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35305","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0029U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA03","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Counseling_ individual_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9002","description":"Counseling_ individual_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6443","description":"Conform band n/s w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB0","description":"ICD-HCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External ambulatory infus pu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0781","description":"External ambulatory infus pu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB0","description":"ICD-LGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC11","description":"ICD-1AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME1","description":"ICD-OIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc mechanical fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85547","description":"Rbc mechanical fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD1","description":"ICD-BAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reuse diaper/brief any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4539","description":"Reuse diaper/brief any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC1","description":"ICD-OLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD0","description":"ICD-BGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA1","description":"ICD-JGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29046","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33697","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon metas noevid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9088","description":"Onc dx colon metas noevid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fistulization of sclera for glaucoma_ through ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123T","description":"Fistulization of sclera for glaucoma_ through ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF1","description":"ICD-OJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF0","description":"ICD-HFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB0","description":"ICD-FAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Large disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4541","description":"Large disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA0","description":"ICD-KBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8I","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA0","description":"ICD-NLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg >48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0746","description":"Absorp drg >48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF1","description":"ICD-OBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD1","description":"ICD-CAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF0","description":"ICD-KETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33289","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB0","description":"ICD-NFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Progenamatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4222","description":"Progenamatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE0","description":"ICD-JHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF0","description":"ICD-ODRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF1","description":"ICD-EDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF0","description":"ICD-GDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD0","description":"ICD-OCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocollator unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0239","description":"Hydrocollator unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Veneer repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2983","description":"Veneer repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0964T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","description":"CPT-0964T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB146","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56633","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE0","description":"ICD-NBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Single vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9152","description":"Single vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0534T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt no ther chg or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9650","description":"Doc pt no ther chg or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculate eggs/animal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87250","description":"Virus inoculate eggs/animal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61250","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE0","description":"ICD-GIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA0","description":"ICD-LAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE1","description":"ICD-GCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE1","description":"ICD-OLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB0","description":"ICD-AHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0915","description":"No improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB0","description":"ICD-ODPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D7259","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7259","description":"CDT-D7259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9186","description":"Motor speech goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC0","description":"ICD-FIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA1","description":"ICD-GHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC20","description":"Medium Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Certified translation or sign-language services per visit.","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9990","description":"Certified translation or sign-language services per visit.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1007","description":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker folding adjust/fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0135","description":"Walker folding adjust/fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE1","description":"ICD-OAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31645","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA1","description":"ICD-NEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1088T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1088T","description":"CPT-1088T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA1","description":"ICD-GDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE0","description":"ICD-EBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD0","description":"ICD-PJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC1","description":"ICD-HGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracostomy w/flap drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32036","description":"Thoracostomy w/flap drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB1","description":"ICD-MFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF1","description":"ICD-KBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ coronary venous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1900","description":"Lead_ coronary venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium in urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82340","description":"Assay of calcium in urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46924","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB1","description":"ICD-MACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE260","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1291","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt referral for ect docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4067F","description":"Pt referral for ect docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11981","description":"Insert drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9793","description":"Patient is currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC131","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suture complicate wnd > 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7912","description":"Suture complicate wnd > 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF1","description":"ICD-JDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB0","description":"ICD-ADHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facility-based respite_ 24-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0531","description":"Facility-based respite_ 24-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD0","description":"ICD-LCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD1","description":"ICD-GHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE0","description":"ICD-CFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC231","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB1","description":"ICD-ECAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF0","description":"ICD-KFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC1","description":"ICD-IFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC0","description":"ICD-CIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo removal donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50547","description":"Laparo removal donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA1","description":"ICD-GAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD0","description":"ICD-GCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1086T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1086T","description":"CPT-1086T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE0","description":"ICD-OBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil res waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2016","description":"Habil res waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF0","description":"ICD-IADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA1","description":"ICD-KAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/attach implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65105","description":"Remove eye/attach implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2305","description":"Lens sphcy trifocal 4.0/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA0","description":"ICD-KFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0735T","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA0","description":"ICD-AHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC0","description":"ICD-JEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8907","description":"Magnetic resonance imaging without contrast_ breast; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlordiazepoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1990","description":"Chlordiazepoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD0","description":"ICD-OBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF0","description":"ICD-FAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist 2 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46285","description":"Remove anal fist 2 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4468","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contour seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2294","description":"Contour seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE0","description":"ICD-FGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD0","description":"ICD-ODGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25350","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22558","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC1","description":"ICD-FBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC0","description":"ICD-OJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB1","description":"ICD-HBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_ mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8927","description":"Tee w or w/o fol w/cont_ mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA0","description":"ICD-KGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB0","description":"ICD-BBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC0","description":"ICD-KFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD1","description":"ICD-OHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67316","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED0","description":"ICD-NHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8968","description":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD240","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0660","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","description":"HCPCS-G0660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2371","description":"Injection_ phenylephrine hydrochloride_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Core build-up incl any pins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2950","description":"Core build-up incl any pins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF1","description":"ICD-HCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy cong add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44128","description":"Enterectomy cong add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA05","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9806","description":"HCPCS-C9806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC1","description":"ICD-GDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC220","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC0","description":"ICD-EDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78630","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF0","description":"ICD-EFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult companioncare per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5136","description":"Adult companioncare per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB206","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77318","description":"Brachytx isodose complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA0","description":"ICD-NJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC1","description":"ICD-BFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA1","description":"ICD-OCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC1","description":"ICD-AATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tissue for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20926","description":"Removal of tissue for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB21","description":"ICD-1EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED1","description":"ICD-EIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","description":"HCPCS-Q0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE0","description":"ICD-OJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC0","description":"ICD-GBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA0","description":"ICD-BFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB1","description":"ICD-KGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1708","description":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afluria vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2035","description":"Afluria vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE0","description":"ICD-JFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0628T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE1","description":"ICD-FIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE1","description":"ICD-BHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA0","description":"ICD-CHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30160","description":"Removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF1","description":"ICD-BBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25111","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF1","description":"ICD-MCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0713T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22220","description":"Incis w/discectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8882","description":"No sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC0","description":"ICD-KEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC1","description":"ICD-JHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip bone les deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27066","description":"Remove hip bone les deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF0","description":"ICD-IEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9788","description":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL43","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD1","description":"ICD-BFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","description":"CPT-01636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583T","description":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE1","description":"ICD-ACLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA0","description":"ICD-OFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90671","description":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF0","description":"ICD-GGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA1","description":"ICD-BGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumat walking boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4360","description":"Pneumat walking boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1701","description":"HCPCS-A1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD1","description":"ICD-AIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD1","description":"ICD-GGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85999","description":"Hematology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA0","description":"ICD-KFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC1","description":"ICD-MKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rhophylac injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2791","description":"Rhophylac injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23150","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal fat absorpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3708","description":"Gastrointestinal fat absorpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1028T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1028T","description":"CPT-1028T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30125","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD0","description":"ICD-EBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9995","description":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7208","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC0","description":"ICD-EEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC0","description":"ICD-FEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD0","description":"ICD-ADAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC0","description":"ICD-OFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA0","description":"ICD-FEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7667","description":"Metaproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-51721","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","description":"CPT-51721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF0","description":"ICD-NKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA0","description":"ICD-AABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25316","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58120","description":"Dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD0","description":"ICD-OAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73610","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31240","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit sympathomim diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9348","description":"Hit sympathomim diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB0","description":"ICD-KCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB0","description":"ICD-NHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF1","description":"ICD-KIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp sphincter pressure meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43263","description":"Ercp sphincter pressure meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Administration of home sleep apnea test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9956","description":"Administration of home sleep apnea test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gel-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7326","description":"Gel-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND1","description":"ICD-GBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF1","description":"ICD-OGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC1","description":"ICD-CHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE0","description":"ICD-OIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC0","description":"ICD-JHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA0","description":"ICD-NCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD1","description":"ICD-JAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9812","description":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC0","description":"ICD-CBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1253","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72197","description":"MRI pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB0","description":"ICD-JAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA0","description":"ICD-FCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4302","description":"Complete aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA0","description":"ICD-CEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87540","description":"Legion pneumo dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cad measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8489","description":"Cad measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME1","description":"ICD-GBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE1","description":"ICD-LHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC1","description":"ICD-NAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB1","description":"ICD-HGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37259","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","description":"CPT-37259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eswl for gallstones","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9034","description":"Eswl for gallstones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD1","description":"ICD-CHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD1","description":"ICD-KHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stationary compressed gas 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0424","description":"Stationary compressed gas 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42962","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD1","description":"ICD-GBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE150","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE0","description":"ICD-FCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA1","description":"ICD-PGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB1","description":"ICD-NCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88164","description":"Cytopath tbs c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA0","description":"ICD-IIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED0","description":"ICD-EAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF1","description":"ICD-BDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Circum 28 days or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54161","description":"Circum 28 days or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 max 100uci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9531","description":"I131 max 100uci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA1","description":"ICD-BGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pos elder mal scrn plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8733","description":"Doc pos elder mal scrn plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD1","description":"ICD-JGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB1","description":"ICD-CAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD0","description":"ICD-CFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB1","description":"ICD-HIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1703","description":"HCPCS-A1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA260","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct midface no graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7948","description":"Reconstruct midface no graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7530","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD1","description":"ICD-GBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC1","description":"ICD-HHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA0","description":"ICD-CHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thera par drugs 2 or > admin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9612","description":"Thera par drugs 2 or > admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 4 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90957","description":"Esrd srv 4 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB1","description":"ICD-CIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA0","description":"ICD-CFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF1","description":"ICD-OIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61584","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0681U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681U","description":"CPT-0681U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0426","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0426","description":"CDT-D0426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med reminder serv per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5185","description":"Med reminder serv per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB1","description":"ICD-NDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF1","description":"ICD-BGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0943T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","description":"CPT-0943T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD1","description":"ICD-OCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD1","description":"ICD-OFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of arm infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73092","description":"X-ray exam of arm infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62326","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain canal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61050","description":"Remove brain canal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC206","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78609","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd sftwre prgrm for pc/pda","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2511","description":"Sgd sftwre prgrm for pc/pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tum unknown origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81540","description":"Oncology tum unknown origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF1","description":"ICD-JBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Braf gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81210","description":"Braf gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia interven order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4525F","description":"Neuropsychia interven order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC45","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445T","description":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA1","description":"ICD-FAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35475","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC0","description":"ICD-PHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545T","description":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","description":"HCPCS-J1308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40652","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329U","description":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA1","description":"ICD-FILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA1","description":"ICD-GAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC205","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Porcine implant_ permacol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9364","description":"Porcine implant_ permacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diathermy eg microwave","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97024","description":"Diathermy eg microwave","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked re sleep disturb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4328F","description":"Pt asked re sleep disturb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF0","description":"ICD-DDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with dementia at any time prior to or during the month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1271","description":"Patients with dementia at any time prior to or during the month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1783","description":"vaccine administration-human papillomavirus - Dose 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE0","description":"ICD-KAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intercep dental tx transitn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8060","description":"Intercep dental tx transitn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t3 n0 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9091","description":"Onc dx rectal t3 n0 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD0","description":"ICD-JCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50130","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"System reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9192","description":"System reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC0","description":"ICD-LDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Path rprt w/ pt pn cat et al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3267F","description":"Path rprt w/ pt pn cat et al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart damage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33545","description":"Repair of heart damage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA1","description":"ICD-BCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE0","description":"ICD-CEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF1","description":"ICD-MIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4026","description":"Cast sup hip spica fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF0","description":"ICD-AAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE0","description":"ICD-CIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA1","description":"ICD-KDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF1","description":"ICD-MATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME0","description":"ICD-CAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE0","description":"ICD-FDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF0","description":"ICD-IFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endodontic endosseous implan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3460","description":"Endodontic endosseous implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96936","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA1","description":"ICD-HDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC1","description":"ICD-EABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA0","description":"ICD-ICHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD0","description":"ICD-ECTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tension ring_ vac erect dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7902","description":"Tension ring_ vac erect dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC1","description":"ICD-CBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC0","description":"ICD-EBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE0","description":"ICD-OLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF1","description":"ICD-JEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE1","description":"ICD-PGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC0","description":"ICD-CHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB0","description":"ICD-NIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5654","description":"Socket insert symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monitor cable elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0485","description":"Monitor cable elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD0","description":"ICD-JITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGD1","description":"ICD-FAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA1","description":"ICD-DBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD0","description":"ICD-KDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL53","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2625","description":"Stent_ non-cor_ tem w/del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA0","description":"ICD-CCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL40","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug outreach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0023","description":"Alcohol and/or drug outreach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA1","description":"ICD-GGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB0","description":"ICD-PBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE0","description":"ICD-BAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove limb nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64782","description":"Remove limb nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD0","description":"ICD-CBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID0","description":"ICD-AEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID0","description":"ICD-BHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25275","description":"Repair forearm tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair brake extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0961","description":"Wheelchair brake extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos pain assess no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8509","description":"Pos pain assess no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB1","description":"ICD-JEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE0","description":"ICD-GBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnio or biodmatrix_ inj 1cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4139","description":"Amnio or biodmatrix_ inj 1cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA1","description":"ICD-PFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9300","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9300","description":"HCPCS-C9300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1942","description":"Injection_ aripiprazole lauroxil_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC1","description":"ICD-KBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF1","description":"ICD-BEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"GYPB GNOTYP NTRNS 1 5 SEUX 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190U","description":"GYPB GNOTYP NTRNS 1 5 SEUX 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD1","description":"ICD-FAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43640","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0887","description":"Epoetin beta esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55040","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD0","description":"ICD-GIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35286","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82106","description":"Alpha-fetoprotein amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64818","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0073","description":"Injection_ aztreonam_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fmr1 gene characterization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81244","description":"Fmr1 gene characterization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC0","description":"ICD-AEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilio-mesenteric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35633","description":"Art byp ilio-mesenteric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain spinal cord cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62268","description":"Drain spinal cord cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1842","description":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52276","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air polymer-type A intrauterine foam_ 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9574","description":"Air polymer-type A intrauterine foam_ 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA0","description":"ICD-NEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA1","description":"ICD-JIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","description":"CPT-01270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA0","description":"ICD-NCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient received any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9723","description":"Hospice services for patient received any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE1","description":"ICD-CFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj cervical plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64413","description":"N block inj cervical plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA32","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE1","description":"ICD-GHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1299","description":"Influenza immunization administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC0","description":"ICD-MKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0568U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","description":"CPT-0568U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB0","description":"ICD-JFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE0","description":"ICD-OGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD0","description":"ICD-EEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF0","description":"ICD-EGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image planar sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78453","description":"Ht muscle image planar sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3D","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF1","description":"ICD-CENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF1","description":"ICD-KDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wearable artificial kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1632","description":"Wearable artificial kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE0","description":"ICD-NGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF1","description":"ICD-NKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 quant&revrse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87536","description":"Hiv-1 quant&revrse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD0","description":"ICD-MCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resin three surfaces-anterio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2332","description":"Resin three surfaces-anterio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body mass index docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3008F","description":"Body mass index docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cebpa gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81218","description":"Cebpa gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE0","description":"ICD-CCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","description":"CPT-92930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of primidone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80188","description":"Assay of primidone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0533","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","description":"HCPCS-G0533","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us limited fetus(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76815","description":"Ob us limited fetus(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF0","description":"ICD-AADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA1","description":"ICD-FFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF1","description":"ICD-EHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97169","description":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB1","description":"ICD-DHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc extend prosth init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34825","description":"Endovasc extend prosth init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC1","description":"ICD-MADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD0","description":"ICD-JCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv/aids measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8491","description":"Hiv/aids measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt-venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33948","description":"Ecmo/ecls daily mgmt-venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caster fork","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2396","description":"Caster fork","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conformity evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5020","description":"Conformity evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC1","description":"ICD-CANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","description":"HCPCS-Q4377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC1","description":"ICD-NJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1B","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC1","description":"ICD-JHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9853","description":"Patient admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF1","description":"ICD-KCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE1","description":"ICD-GCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD0","description":"ICD-OHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD0","description":"ICD-NCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB0","description":"ICD-CAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD0","description":"ICD-KCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manipulation of spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22505","description":"Manipulation of spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0604","description":"HCPCS-A0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA1","description":"ICD-OCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA31","description":"ICD-1IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC155","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC0","description":"ICD-ECUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB1","description":"ICD-KAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug admin & hemodynmic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93463","description":"Drug admin & hemodynmic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81345","description":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6558","description":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD1","description":"ICD-IECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services of skilled nurse in home health setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0154","description":"Services of skilled nurse in home health setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63053","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041U","description":"Borrelia burgdorferi_ antibody detection of 5 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sig w/tndsc balloon dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45340","description":"Sig w/tndsc balloon dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF0","description":"ICD-OASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB1","description":"ICD-KDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB250","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA0","description":"ICD-NGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5645","description":"Bk flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC0","description":"ICD-MFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43300","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE1","description":"ICD-MCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE240","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF1","description":"ICD-NLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF1","description":"ICD-FDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF1","description":"ICD-JHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32940","description":"Revision of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF1","description":"ICD-HHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone mineral dual photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78351","description":"Bone mineral dual photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA0","description":"ICD-DCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular graft_ synthetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8670","description":"Vascular graft_ synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0830T","description":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD1","description":"ICD-BFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0596","description":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95070","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJE1","description":"ICD-GAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59400","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE1","description":"ICD-AFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC0","description":"ICD-FGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF0","description":"ICD-NLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19286","description":"Perq dev breast add us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA0","description":"ICD-OHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5644","description":"Above knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC1","description":"ICD-OKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn bilat hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5100","description":"Body-worn bilat hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-medical Transportation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6110","description":"Non-medical Transportation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ado-trastuzumab emt 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9354","description":"Inj_ ado-trastuzumab emt 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE1","description":"ICD-IITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lith ion non prosth recharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4601","description":"Lith ion non prosth recharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA40","description":"Default_ /60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC0","description":"ICD-FBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE1","description":"ICD-MAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ed svc ckd ind per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0420","description":"Ed svc ckd ind per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF0","description":"ICD-OEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5953","description":"Adult speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC1","description":"ICD-IGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC1","description":"ICD-BAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3B","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct toric prism ballast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2511","description":"Cntct toric prism ballast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation hand complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20808","description":"Replantation hand complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA1","description":"ICD-JINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC1","description":"ICD-FDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF0","description":"ICD-GDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8A","description":"Medium Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29845","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB0","description":"ICD-PKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA0","description":"ICD-KIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD115","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD1","description":"ICD-CCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD0","description":"ICD-KHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bath conductivity meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1550","description":"Bath conductivity meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54530","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF0","description":"ICD-JFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1026","description":"Ped compr care pkg_ per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","description":"HCPCS-J1809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC0","description":"ICD-OHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm each wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0113","description":"Crutch underarm each wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC1","description":"ICD-NCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA1","description":"ICD-BDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special eye exam subsequent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92226","description":"Special eye exam subsequent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE0","description":"ICD-GDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92945","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","description":"CPT-92945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB1","description":"ICD-GHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA1","description":"ICD-GAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lefamulin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0691","description":"Injection_ lefamulin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE0","description":"ICD-GHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gum tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41830","description":"Removal of gum tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC1","description":"ICD-OEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE0","description":"ICD-JHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29860","description":"Hip arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carry current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8984","description":"Carry current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA21","description":"ICD-3IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0B","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC1","description":"ICD-IBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB0","description":"ICD-KAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD0","description":"ICD-KBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1301","description":"HCPCS-A1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC1","description":"ICD-OAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE0","description":"ICD-NCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD1","description":"ICD-NHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81219","description":"Calr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF1","description":"ICD-KDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoskel knee-shin mnl lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5810","description":"Endoskel knee-shin mnl lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC160","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76805","description":"Ob us >/= 14 wks sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99476","description":"Ped crit care age 2-5 subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD1","description":"ICD-OLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 1-4 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99382","description":"Init pm e/m new pat 1-4 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Halo cerv into milwaukee typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0830","description":"Halo cerv into milwaukee typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB1","description":"ICD-AFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD0","description":"ICD-OFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 3 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95132","description":"Immntx 3 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA0","description":"ICD-AFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fetal fibronectin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82731","description":"Assay of fetal fibronectin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA1","description":"ICD-PCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB0","description":"ICD-CGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD0","description":"ICD-ECUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB0","description":"ICD-MDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42975","description":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC1","description":"ICD-CCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE0","description":"ICD-NJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy inject material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52327","description":"Cystoscopy inject material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE0","description":"ICD-GAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no lipid profile","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8726","description":"Doc reas no lipid profile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC0","description":"ICD-ABUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA33","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25515","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB0","description":"ICD-PEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA0","description":"ICD-FGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF1","description":"ICD-EAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC1","description":"ICD-PHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA0","description":"ICD-CBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA1","description":"ICD-FBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF1","description":"ICD-GIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC0","description":"ICD-KGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC1","description":"ICD-PERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4207","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4207","description":"HCPCS-Q4207","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38780","description":"Remove abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-H0053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","description":"HCPCS-H0053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA0","description":"ICD-GALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC0","description":"ICD-DEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28060","description":"Partial removal foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC0","description":"ICD-LERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB0","description":"ICD-KDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE0","description":"ICD-GFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical performance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97750","description":"Physical performance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF0","description":"ICD-MEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC0","description":"ICD-MBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0903","description":"CDT-D0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD1","description":"ICD-CHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44390","description":"Colonoscopy for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD1","description":"ICD-OJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33367","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE1","description":"ICD-OAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2635","description":"Brachytx_ non-str_ ha_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA1","description":"ICD-OLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v >/= 1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3084F","description":"Kt/v >/= 1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC1","description":"ICD-CELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical conference_ 60 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0221","description":"Medical conference_ 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF0","description":"ICD-FBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE1","description":"ICD-GDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF1","description":"ICD-MCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB0","description":"ICD-CGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6256","description":"Absorpt drg > 48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD0","description":"ICD-CCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD0","description":"ICD-JBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA1","description":"ICD-JILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB1","description":"ICD-PLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc a stim case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4017","description":"Ivf canc a stim case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43763","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA0","description":"ICD-KDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0461","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor pancreas/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48552","description":"Prep donor pancreas/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5298","description":"Hearing aid noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF1","description":"ICD-FIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA1","description":"ICD-PFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA0","description":"ICD-CANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Porcelain/ceramic inlay 2srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6600","description":"Porcelain/ceramic inlay 2srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB1","description":"ICD-DIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive remover per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4455","description":"Adhesive remover per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE0","description":"ICD-FCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec rpt no doc class histo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9425","description":"Spec rpt no doc class histo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA0","description":"ICD-CDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93786","description":"Ambulatory bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF0","description":"ICD-JEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA0","description":"ICD-OJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD1","description":"ICD-ABUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF1","description":"ICD-FBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r0 res no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9105","description":"Onc dx pancreatc p r0 res no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31390","description":"Removal of larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay c-d transfer measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82373","description":"Assay c-d transfer measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD1","description":"ICD-NBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD0","description":"ICD-KGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0853T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hygienic item or device_ disposable or non-disposable_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9286","description":"Hygienic item or device_ disposable or non-disposable_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443U","description":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incompl donor egg case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4023","description":"Incompl donor egg case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE1","description":"ICD-BBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53210","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA1","description":"ICD-AIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polishing artifical eye","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2624","description":"Polishing artifical eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0885","description":"Pwc gp4 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0314","description":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD0","description":"ICD-CELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF0","description":"ICD-BCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD1","description":"ICD-IBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE0","description":"ICD-FFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent tobacco status is not tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9792","description":"Most recent tobacco status is not tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rout foot care per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0390","description":"Rout foot care per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo examination procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76999","description":"Echo examination procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8428","description":"Ready gradient gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interro eval npgs sleep apne","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434T","description":"Interro eval npgs sleep apne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6925","description":"Wrist disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB1","description":"ICD-OHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF1","description":"ICD-BFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj/inhib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86977","description":"Rbc serum pretx incubj/inhib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17451","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE0","description":"ICD-DIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB0","description":"ICD-KCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6751","description":"Crown porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36221","description":"Place cath thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC1","description":"ICD-BFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF0","description":"ICD-KFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain transmis data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0610T","description":"Mrs disc pain transmis data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC1","description":"ICD-JCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456U","description":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC21","description":"ICD-4BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aud brainstem implt programg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92640","description":"Aud brainstem implt programg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5761","description":"Denture reln part mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9731","description":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB210","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD1","description":"ICD-OJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA1","description":"ICD-JITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","description":"HCPCS-Q4416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1025","description":"Nonpneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF0","description":"ICD-NIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC0","description":"ICD-GFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA05","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA0","description":"ICD-GBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 4 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71048","description":"Radiologic examination_ chest; 4 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC1","description":"ICD-BIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD1","description":"ICD-CIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0065U","description":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA0","description":"ICD-GEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA1","description":"ICD-CHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE0","description":"ICD-BIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF1","description":"ICD-DCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD0","description":"ICD-CALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF1","description":"ICD-KFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ESCHERICHIA COLI 0157","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87335","description":"IAAD IA ESCHERICHIA COLI 0157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0503U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","description":"CPT-0503U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0401","description":"HCPCS-C0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21813","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB1","description":"ICD-OCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF1","description":"ICD-JBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB1","description":"ICD-FDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA0","description":"ICD-FGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2B","description":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1026","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us quant a only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76511","description":"Ophth us quant a only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB0","description":"ICD-FBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA1","description":"ICD-MHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB1","description":"ICD-DCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD0","description":"ICD-CAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6027","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image spect mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78452","description":"Ht muscle image spect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul trial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282T","description":"Periph field stimul trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF1","description":"ICD-PJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE1","description":"ICD-FANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC0","description":"ICD-CCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-RUC01","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"RUC01","description":"ICD-RUC01","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB0","description":"ICD-AETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36578","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE0","description":"ICD-JFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA1","description":"ICD-AHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34820","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD0","description":"ICD-OAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA1","description":"ICD-NEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","description":"HCPCS-J3373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB0","description":"ICD-JAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add half sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3530","description":"Ortho shoe add half sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF1","description":"ICD-KGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF1","description":"ICD-FIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21820","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein_ direct measurement; small dense LDL cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83722","description":"Lipoprotein_ direct measurement; small dense LDL cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD1","description":"ICD-CGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC0","description":"ICD-LDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB21","description":"ICD-1FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB1","description":"ICD-LAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64491","description":"Inj paravert f jnt c/t 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1012T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","description":"CPT-1012T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB1","description":"ICD-DAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF1","description":"ICD-CDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF1","description":"ICD-BHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB1","description":"ICD-NKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33820","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0457","description":"Chest shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 15-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88262","description":"Chromosome analysis 15-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD0","description":"ICD-FEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ampho b cholesteryl sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0288","description":"Ampho b cholesteryl sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE0","description":"ICD-CCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC0","description":"ICD-GFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9929","description":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient achieved a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9810","description":"Patient achieved a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD0","description":"ICD-FDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF1","description":"ICD-PLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0548U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","description":"CPT-0548U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE0","description":"ICD-MKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE1","description":"ICD-OKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB1","description":"ICD-FFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME1","description":"ICD-OAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF1","description":"ICD-BDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Access av dial grft for eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36147","description":"Access av dial grft for eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67914","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA0","description":"ICD-KFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE0","description":"ICD-GIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE0","description":"ICD-BHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32552","description":"Remove lung catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF1","description":"ICD-CHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF0","description":"ICD-NFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA0","description":"ICD-AIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB1","description":"ICD-JIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0741T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9841","description":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA1","description":"ICD-AIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF0","description":"ICD-BABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC0","description":"ICD-IGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64864","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0594","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF0","description":"ICD-NJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Handgrip for cane etc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4636","description":"Handgrip for cane etc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB140","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB11","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collect blood from picc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36592","description":"Collect blood from picc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0551","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","description":"HCPCS-G0551","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD0","description":"ICD-CDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA1","description":"ICD-CEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99380","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC0","description":"ICD-CHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC0","description":"ICD-DCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB0","description":"ICD-LAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE0","description":"ICD-MJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF0","description":"ICD-IHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0920T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","description":"CPT-0920T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD1","description":"ICD-OBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Torsion mechanism wrist/elbo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3891","description":"Torsion mechanism wrist/elbo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA0","description":"ICD-KCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC1","description":"ICD-JIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF0","description":"ICD-KAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA1","description":"ICD-LBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE1","description":"ICD-IALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"A/d tx program_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2036","description":"A/d tx program_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD0","description":"ICD-AALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB0","description":"ICD-IGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5C","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0560T","description":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relese_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4257","description":"Relese_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE0","description":"ICD-NGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69421","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA1","description":"ICD-HDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0068U","description":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77610","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME0","description":"ICD-MCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepc measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8545","description":"Hepc measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80332","description":"Antidepressants class 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA0","description":"ICD-GHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rectum surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45999","description":"Rectum surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB32","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD0","description":"ICD-JICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB0","description":"ICD-CCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC1","description":"ICD-MEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7554","description":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy tubal cautery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58670","description":"Laparoscopy tubal cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA1","description":"ICD-BIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA1","description":"ICD-ADTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC1","description":"ICD-IFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC31","description":"ICD-2DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB0","description":"ICD-GHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9924","description":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2045","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","description":"HCPCS-A2045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylnaltrexone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2212","description":"Methylnaltrexone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for wrist x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25246","description":"Injection for wrist x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE0","description":"ICD-OABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA0","description":"ICD-LFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA1","description":"ICD-MKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF1","description":"ICD-OKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport meals recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0190","description":"Noner transport meals recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA1","description":"ICD-FCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB1","description":"ICD-LEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB1","description":"ICD-JBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF1","description":"ICD-FDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24620","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet image full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78813","description":"Pet image full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place needles h&n for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41019","description":"Place needles h&n for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd accessory noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2599","description":"Sgd accessory noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef blenderized foods","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4149","description":"Ef blenderized foods","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC21","description":"ICD-3DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA0","description":"ICD-OITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","description":"HCPCS-A4543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay nonendocrine receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84238","description":"Assay nonendocrine receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC1","description":"ICD-MFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD1","description":"ICD-IHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD0","description":"ICD-CGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF0","description":"ICD-BCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX15","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1007","description":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"One way chest drain valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7040","description":"One way chest drain valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5821","description":"Denture interm part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No order for ceph no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9198","description":"No order for ceph no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA0","description":"ICD-IDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01829","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","description":"CPT-01829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21432","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC0","description":"ICD-ICEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB0","description":"ICD-FGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25490","description":"Reinforce radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37140","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c rna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87520","description":"Hepatitis c rna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF1","description":"ICD-BBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9062","description":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC1","description":"ICD-LIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF0","description":"ICD-KCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF0","description":"ICD-JCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7557","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC1","description":"ICD-JGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA1","description":"ICD-MJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg >8min <=20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2502","description":"Sgd prerec msg >8min <=20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE240","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF0","description":"ICD-DCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of external ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69105","description":"Biopsy of external ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB1","description":"ICD-KBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62365","description":"Remove spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF1","description":"ICD-BGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48146","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA1","description":"ICD-NKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF0","description":"ICD-GEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Anifrolumab-Fnia_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9086","description":"Injection_ Anifrolumab-Fnia_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of chest tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32551","description":"Insertion of chest tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD1","description":"ICD-OCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC1","description":"ICD-KAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC140","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB1","description":"ICD-GARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD1","description":"ICD-KFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC1","description":"ICD-NLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA0","description":"ICD-MFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cauterization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57510","description":"Cauterization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA53","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pouch clsd w barr attached","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5051","description":"Pouch clsd w barr attached","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF1","description":"ICD-IGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE117","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE1","description":"ICD-MLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57100","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC0","description":"ICD-CATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE254","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE0","description":"ICD-METE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD0","description":"ICD-CDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91316","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE1","description":"ICD-OEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0407","description":"Inpt/tele follow up 25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID1","description":"ICD-EDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE0","description":"ICD-PFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB1","description":"ICD-CEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plumb/elec wk hm hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4870","description":"Plumb/elec wk hm hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD0","description":"ICD-MBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD0","description":"ICD-GCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meals when receive services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1010","description":"Meals when receive services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB1","description":"ICD-CDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28116","description":"Revision of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA1","description":"ICD-FDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD1","description":"ICD-ICCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC1","description":"ICD-CEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF0","description":"ICD-NHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA1","description":"ICD-NHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA1","description":"ICD-GHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB54","description":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2207","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB0","description":"ICD-ABCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC1","description":"ICD-OHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specimen site not esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8797","description":"Specimen site not esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0795T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD1","description":"ICD-KAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF0","description":"ICD-OFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","description":"HCPCS-M1427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF1","description":"ICD-BFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25907","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF0","description":"ICD-CCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2121","description":"Lenticular lens_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA1","description":"ICD-OIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA1","description":"ICD-JBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical home_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0281","description":"Medical home_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE0","description":"ICD-JHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2118","description":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYTOG CONST ALYS INTERROG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209U","description":"CYTOG CONST ALYS INTERROG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99418","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE0","description":"ICD-IDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC0","description":"ICD-BGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF1","description":"ICD-MJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0330","description":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA1","description":"ICD-HGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ketamine and norketamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80357","description":"Ketamine and norketamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF0","description":"ICD-EHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA1","description":"ICD-GDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA1","description":"ICD-IEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88239","description":"Tissue culture tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75580","description":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB0","description":"ICD-JATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99483","description":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial mastectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19301","description":"Partial mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD1","description":"ICD-KCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC0","description":"ICD-KGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA1","description":"ICD-OAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE1","description":"ICD-MGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA0","description":"ICD-JINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD1","description":"ICD-KHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC1","description":"ICD-HAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE1","description":"ICD-PEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC0","description":"ICD-OALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF1","description":"ICD-FFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC1","description":"ICD-NGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE1","description":"ICD-CBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED1","description":"ICD-IIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD1","description":"ICD-FAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB0","description":"ICD-OCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC1","description":"ICD-NJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB0","description":"ICD-AGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD216","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDED0","description":"ICD-NDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chct for mal hyperthermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89049","description":"Chct for mal hyperthermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC1","description":"ICD-FCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3230","description":"Chlorpromazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB0","description":"ICD-OIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genetic counsel 15 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0265","description":"Genetic counsel 15 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA117","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture bacteria anaerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87073","description":"Culture bacteria anaerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE1","description":"ICD-BCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nipple exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19110","description":"Nipple exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self care mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97535","description":"Self care mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7607","description":"Levalbuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF0","description":"ICD-JBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA0","description":"ICD-PLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB120","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lacer molded to patient mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2330","description":"Lacer molded to patient mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF1","description":"ICD-BDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90875","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC1","description":"ICD-PGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA1","description":"ICD-FCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF1","description":"ICD-MCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB1","description":"ICD-NEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal 4.00d/.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2203","description":"Lens sphcyl bifocal 4.00d/.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55700","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE1","description":"ICD-OEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE215","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polycentric hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6600","description":"Polycentric hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF0","description":"ICD-KHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51865","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76498","description":"MRI procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF1","description":"ICD-FGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF1","description":"ICD-OBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NFCT AGT HIV GNRJ SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219U","description":"NFCT AGT HIV GNRJ SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1743","description":"HCPCS-C1743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar or lumbar rib pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1040","description":"Lumbar or lumbar rib pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406U","description":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD1","description":"ICD-FDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90695","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","description":"CPT-90695","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2141","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE0","description":"ICD-OCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC0","description":"ICD-JCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2101","description":"HCPCS-A2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15941","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE1","description":"ICD-GADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF1","description":"ICD-NGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA1","description":"ICD-KCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oritavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2407","description":"Injection_ oritavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF1","description":"ICD-LFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abciximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0130","description":"Abciximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sermorelin acetate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0515","description":"Sermorelin acetate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF0","description":"ICD-CEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF0","description":"ICD-GIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF1","description":"ICD-FDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); binding antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86041","description":"Acetylcholine receptor (AChR); binding antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC114","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1C","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE1","description":"ICD-EEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0565","description":"HCPCS-G0565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee joint cam lock each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2415","description":"Knee joint cam lock each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collect & prep saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0417","description":"Collect & prep saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA0","description":"ICD-PKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB1","description":"ICD-BBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB1","description":"ICD-OITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl nasal pillow comb mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7029","description":"Repl nasal pillow comb mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE0","description":"ICD-KCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx iliac spine uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0412","description":"Open tx iliac spine uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC1","description":"ICD-PLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63015","description":"Remove spine lamina >2 crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interim labor facility globa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4005","description":"Interim labor facility globa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscope us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45391","description":"Colonoscopy w/endoscope us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31256","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64628","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF0","description":"ICD-JHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xray place prox ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75958","description":"Xray place prox ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE1","description":"ICD-CBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD1","description":"ICD-DAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE1","description":"ICD-MDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC1","description":"ICD-GBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD0","description":"ICD-BIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC1","description":"ICD-EIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD1","description":"ICD-NDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD0","description":"ICD-OBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC1","description":"ICD-CGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9989","description":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31080","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC1","description":"ICD-NKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD0","description":"ICD-GDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate upper arm & implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24931","description":"Amputate upper arm & implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE0","description":"ICD-NEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB1","description":"ICD-KFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF1","description":"ICD-JEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paramedicintercep nonhospals","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0207","description":"Paramedicintercep nonhospals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99201","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1771","description":"Rep dev_ urinary_ w/sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF1","description":"ICD-OCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2301","description":"Pwr standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/clt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87904","description":"Phenotype dna hiv w/clt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC0","description":"ICD-CAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE0","description":"ICD-FIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA0","description":"ICD-MBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile duct endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74328","description":"X-ray bile duct endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC1","description":"ICD-GIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit routine device maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5035","description":"Hit routine device maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF1","description":"ICD-FBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES117","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC1","description":"ICD-BGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF0","description":"ICD-CFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC1","description":"ICD-KHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7650","description":"Open red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33274","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dispens fee immunosupressive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0510","description":"Dispens fee immunosupressive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Straight knee joint heavy du","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2385","description":"Straight knee joint heavy du","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA0","description":"ICD-KFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD0","description":"ICD-OEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF1","description":"ICD-BDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA144","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5C","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE1","description":"ICD-KISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB1","description":"ICD-GAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attached to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0920","description":"Fracture frame attached to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF0","description":"ICD-OLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81513","description":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE1","description":"ICD-GATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE1","description":"ICD-LCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87451","description":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","description":"HCPCS-M0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX32","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of digit nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64831","description":"Repair of digit nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA0","description":"ICD-OBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excavation of a tooth resulting in the determination of non-restorability","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2989","description":"Excavation of a tooth resulting in the determination of non-restorability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1146","description":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92979","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD1","description":"ICD-GBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF1","description":"ICD-GGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA0","description":"ICD-GIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF0","description":"ICD-DAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF1","description":"ICD-GFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0901","description":"HCPCS-C0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD0","description":"ICD-GHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF0","description":"ICD-OHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF0","description":"ICD-JCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Certolizumab pegol inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0717","description":"Certolizumab pegol inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180T","description":"64 lead ecg w/i&r only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD0","description":"ICD-KIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 1 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2610","description":"Inlay porcelain/ceramic 1 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49618","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microsomal antibody each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86376","description":"Microsomal antibody each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC136","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB21","description":"ICD-4GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB1","description":"ICD-IEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED0","description":"ICD-GHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND0","description":"ICD-GAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF1","description":"ICD-OJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0028","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA1","description":"ICD-OICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB0","description":"ICD-BHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB1","description":"ICD-GBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF1","description":"ICD-LDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93597","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1183","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB0","description":"ICD-KBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC0","description":"ICD-DGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA1","description":"ICD-FABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61321","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA1","description":"ICD-OLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0672T","description":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX45","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB1","description":"ICD-MJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED1","description":"ICD-NGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph scope w/sclerosis inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43204","description":"Esoph scope w/sclerosis inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML53","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1B","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA1","description":"ICD-DFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_eptinezumab-jjmr_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9063","description":"Injection_eptinezumab-jjmr_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt cat/pn cat/hist grd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3260F","description":"Pt cat/pn cat/hist grd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unusual physician travel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99082","description":"Unusual physician travel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF1","description":"ICD-GISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC1","description":"ICD-PHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD1","description":"ICD-BCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD1","description":"ICD-FGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38555","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67299","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA1","description":"ICD-OEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE0","description":"ICD-PKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0143U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01999","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","description":"CPT-01999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD0","description":"ICD-KAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anabolic steroid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80327","description":"Anabolic steroid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF0","description":"ICD-DDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31200","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF1","description":"ICD-PLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25116","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD0","description":"ICD-IFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release eye tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67343","description":"Release eye tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD1","description":"ICD-OAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC0","description":"ICD-FCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0562U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","description":"CPT-0562U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE121","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA0","description":"ICD-FHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF0","description":"ICD-MBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venous pressure clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4918","description":"Venous pressure clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES360","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB0","description":"ICD-IGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC1","description":"ICD-GGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF1","description":"ICD-FDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0872T","description":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hypoxia response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94450","description":"Hypoxia response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE0","description":"ICD-BCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm ear level receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5284","description":"Ald fm/dm ear level receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE0","description":"ICD-JACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE1","description":"ICD-OCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA1","description":"ICD-FHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC1","description":"ICD-GANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB1","description":"ICD-IAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43325","description":"Revise esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 3999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4724","description":"Dialys sol fld vol > 3999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9794","description":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50546","description":"Laparoscopic nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In ear binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5130","description":"In ear binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA1","description":"ICD-OJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wbc alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85540","description":"Wbc alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB0","description":"ICD-ADMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smear wet mount saline/ink","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87210","description":"Smear wet mount saline/ink","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21387","description":"Opn tx orbit fx combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0132U","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA1","description":"ICD-GECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD0","description":"ICD-OHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20240","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear microscopy examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92504","description":"Ear microscopy examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special joystick handle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2323","description":"Special joystick handle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neostim tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4265","description":"Neostim tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45500","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF1","description":"ICD-CGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC1","description":"ICD-NCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC0","description":"ICD-FETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC154","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC0","description":"ICD-KEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC0","description":"ICD-JIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99284","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC0","description":"ICD-OJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF1","description":"ICD-GCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC1","description":"ICD-OCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8C","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF0","description":"ICD-FGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC0","description":"ICD-GCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE0","description":"ICD-FCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE1","description":"ICD-CGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0769T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB0","description":"ICD-CCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA1","description":"ICD-LEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd dilate stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43245","description":"Egd dilate stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7211","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain outer ear canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69020","description":"Drain outer ear canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3376F","description":"Ajcc brstcncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA0","description":"ICD-MEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9783","description":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92538","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl garment for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0608","description":"Repl garment for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA0","description":"ICD-EHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA1","description":"ICD-BBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asth controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9432","description":"Asth controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75970","description":"Vascular biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dwelling lead investigation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1029","description":"Dwelling lead investigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED0","description":"ICD-KDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD1","description":"ICD-MFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE0","description":"ICD-JFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC0","description":"ICD-AFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB1","description":"ICD-OGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF1","description":"ICD-FCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA1","description":"ICD-BHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF0","description":"ICD-NBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA0","description":"ICD-HDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65870","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC1","description":"ICD-NLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9308","description":"HCPCS-C9308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC0","description":"ICD-OCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain acquisj data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0609T","description":"Mrs disc pain acquisj data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32670","description":"Thoracoscopy bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0046","description":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE0","description":"ICD-LEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC0","description":"ICD-GIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ibalizumab-uiyk_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1746","description":"Injection_ ibalizumab-uiyk_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50572","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA0","description":"ICD-OFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC0","description":"ICD-BFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD0","description":"ICD-OEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27386","description":"Repair/graft of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1503","description":"HCPCS-C1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23700","description":"Fixation of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF0","description":"ICD-MGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of mammary ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77054","description":"X-ray of mammary ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD1","description":"ICD-FHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0702","description":"CDT-D0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE1","description":"ICD-JFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC1","description":"ICD-NLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC1","description":"ICD-KCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cell cryopreserve/storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88240","description":"Cell cryopreserve/storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD1","description":"ICD-AFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC0","description":"ICD-CDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21452","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA1","description":"ICD-NFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9881","description":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC1","description":"ICD-PFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80422","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC1","description":"ICD-KAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shigella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86771","description":"Shigella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL40","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins lt atrl mont pres lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294T","description":"Ins lt atrl mont pres lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0057","description":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6602","description":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB1","description":"ICD-FFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE1","description":"ICD-OAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63271","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE0","description":"ICD-CHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of face wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15828","description":"Removal of face wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0496","description":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB1","description":"ICD-KBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF1","description":"ICD-LCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD0","description":"ICD-NACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80400","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF1","description":"ICD-EIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB1","description":"ICD-CGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE1","description":"ICD-BCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","description":"CPT-01210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC52","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6536","description":"Gc stocking full lngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77075","description":"X-rays bone survey complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of citrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82507","description":"Assay of citrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB0","description":"ICD-PEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB0","description":"ICD-AHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA1","description":"ICD-GHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB0","description":"ICD-GDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE1","description":"ICD-KGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC0","description":"ICD-GAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD1","description":"ICD-AECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant temple bone w/stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69714","description":"Implant temple bone w/stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso trnk sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0454","description":"Tlso trnk sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX52","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB1","description":"ICD-NEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE0","description":"ICD-JETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD1","description":"ICD-ICHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92273","description":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC1","description":"ICD-CHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229U","description":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84252","description":"Assay of vitamin b-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD0","description":"ICD-OGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD1","description":"ICD-FDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA0","description":"ICD-NJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA1","description":"ICD-BEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0651U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0651U","description":"CPT-0651U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF0","description":"ICD-JHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84651","description":"Anesth hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF1","description":"ICD-IDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE1","description":"ICD-LAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Who w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3906","description":"Who w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA1","description":"ICD-KAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01968","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","description":"CPT-01968","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC0","description":"ICD-IIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC0","description":"ICD-JGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2005","description":"HCPCS-A2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8424","description":"Ready gradient sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF1","description":"ICD-NCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF1","description":"ICD-EDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX40","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE1","description":"ICD-NBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knees","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73565","description":"X-ray exam of knees","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture type immunologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87147","description":"Culture type immunologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA1","description":"ICD-HDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Store prev froz embryos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4027","description":"Store prev froz embryos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1087","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA1","description":"ICD-PEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7318","description":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND1","description":"ICD-KBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB1","description":"ICD-JCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg ak ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5430","description":"Postop dsg ak ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA1","description":"ICD-GCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1943","description":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD1","description":"ICD-CAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2206","description":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID0","description":"ICD-EDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD0","description":"ICD-OFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal leg bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27360","description":"Partial removal leg bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/substance abuse skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1012","description":"Alcohol/substance abuse skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No off assis eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9382","description":"No off assis eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB1","description":"ICD-HDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0840T","description":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF0","description":"ICD-KBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11308","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20670","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF0","description":"ICD-NFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD0","description":"ICD-HHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD0","description":"ICD-GBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vibrate quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107T","description":"Vibrate quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prednisone ir or dr oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7512","description":"Prednisone ir or dr oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA0","description":"ICD-OHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37248","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0667T","description":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No hcv infect srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9454","description":"No hcv infect srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39545","description":"Revision of diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB1","description":"ICD-OKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remis 6m w/6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9573","description":"Remis 6m w/6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE1","description":"ICD-NKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA1","description":"ICD-KBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA0","description":"ICD-KDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB36","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pow mobil dev no dmepdac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0899","description":"Pow mobil dev no dmepdac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC1","description":"ICD-ODTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB0","description":"ICD-NDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB1","description":"ICD-CDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD1","description":"ICD-NITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tcd vasoreactivity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93890","description":"Tcd vasoreactivity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD1","description":"ICD-KGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF1","description":"ICD-OFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","description":"HCPCS-Q4412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE0","description":"ICD-MLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41826","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA1","description":"ICD-NBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB1","description":"ICD-NDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2C","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE1","description":"ICD-NHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD1","description":"ICD-EALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF0","description":"ICD-OFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC1","description":"ICD-ECHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC1","description":"ICD-OFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA1","description":"ICD-GHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Door to punc time <2hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9580","description":"Door to punc time <2hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF1","description":"ICD-FFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB1","description":"ICD-OBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB0","description":"ICD-LASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC241","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1039T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1039T","description":"CPT-1039T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0855","description":"Pwc gp 3 xhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC1","description":"ICD-PKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD0","description":"ICD-KFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF0","description":"ICD-OBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA0","description":"ICD-ABCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF1","description":"ICD-MLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF1","description":"ICD-FBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Humate-p_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7187","description":"Humate-p_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF1","description":"ICD-DIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay toxin or antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87230","description":"Assay toxin or antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE1","description":"ICD-BCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37282","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","description":"CPT-37282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-vertebrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35645","description":"Art byp subclav-vertebrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4532","description":"Ped size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0830","description":"Pwc gp2 std seat elevate s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped gastro ed given caregvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4058F","description":"Ped gastro ed given caregvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD0","description":"ICD-NHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD0","description":"ICD-CCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD1","description":"ICD-BDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 3 booster","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023A","description":"Fee covid-19 vac 3 booster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF1","description":"ICD-KDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293U","description":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA1","description":"ICD-DGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA1","description":"ICD-JFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA1","description":"ICD-FDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF0","description":"ICD-GEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE0","description":"ICD-JCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open chest heart massage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32160","description":"Open chest heart massage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF0","description":"ICD-CBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1477","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","description":"HCPCS-M1477","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML1ST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111A","description":"ADM SARSCOV2 25MCG/0.25ML1ST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2080","description":"Hkafo unilat torsion cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Belinostat_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9442","description":"Injection_ Belinostat_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE1","description":"ICD-KIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt instr nrml activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4245F","description":"Pt instr nrml activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB1","description":"ICD-ACTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD0","description":"ICD-JCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE0","description":"ICD-OCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB0","description":"ICD-AAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy single cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63040","description":"Laminotomy single cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB1","description":"ICD-BATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 12.6-20 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12055","description":"Intmd rpr face/mm 12.6-20 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC1","description":"ICD-NHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81279","description":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA0","description":"ICD-ICCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and radiotracer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52250","description":"Cystoscopy and radiotracer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84156","description":"Assay of protein urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC52","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA0","description":"ICD-GAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intra-articular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79440","description":"Nuclear rx intra-articular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD0","description":"ICD-OLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD1","description":"ICD-OGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE0","description":"ICD-KBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB1","description":"ICD-BAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect face/scalp tum 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21016","description":"Resect face/scalp tum 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valrubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9357","description":"Valrubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine & skull spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22590","description":"Spine & skull spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC0","description":"ICD-CDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3D","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1250","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC1","description":"ICD-CFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB1","description":"ICD-IACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA1","description":"ICD-BGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65270","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA0","description":"ICD-JHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1503","description":"CDT-D1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB30","description":"Low Rehab_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA31","description":"ICD-4JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0255","description":"Hospital bed var ht w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC0","description":"ICD-GDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA0","description":"ICD-KGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92313","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8F","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC0","description":"ICD-NAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC1","description":"ICD-BDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual wc accessory_ handrim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2205","description":"Manual wc accessory_ handrim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF0","description":"ICD-DFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso flex no ri stays pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0628","description":"Lso flex no ri stays pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD0","description":"ICD-CGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fluphenazine hcl_ 1.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2679","description":"Injection_ fluphenazine hcl_ 1.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC0","description":"ICD-CABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC0","description":"ICD-JFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periradicular surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3427","description":"Periradicular surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC07","description":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA1","description":"ICD-PBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE0","description":"ICD-LHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0029","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75574","description":"Ct angio hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008U","description":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1089","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD1","description":"ICD-IGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL12","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1260","description":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC0","description":"ICD-NCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC21","description":"ICD-1GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9225","description":"Norsn no foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44345","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400U","description":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB0","description":"ICD-ECAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF1","description":"ICD-HBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD0","description":"ICD-CFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86611","description":"Bartonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE0","description":"ICD-OJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29405","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29861","description":"Hip arthro w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9805","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE0","description":"ICD-CAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8995","description":"Sub pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31090","description":"Exploration of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC56","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35702","description":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML22","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA1","description":"ICD-JFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA1","description":"ICD-NGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD1","description":"ICD-ECUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB0","description":"ICD-OANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3A","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC1","description":"ICD-NCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0768T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD1","description":"ICD-PBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC1","description":"ICD-FDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF1","description":"ICD-DGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27052","description":"Biopsy of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF0","description":"ICD-CAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracostomy w/rib resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32035","description":"Thoracostomy w/rib resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA11","description":"ICD-4BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9918","description":"Functional status not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD0","description":"ICD-NEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC1","description":"ICD-CILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA1","description":"ICD-KHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35226","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27033","description":"Exploration of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reposition pacing-defib lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33215","description":"Reposition pacing-defib lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF0","description":"ICD-NDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC21","description":"ICD-1FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2252","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/replace ur sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53447","description":"Remove/replace ur sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD1","description":"ICD-GBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD1","description":"ICD-CDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2030","description":"Kafo dbl solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-htn/htn_ no f/u_ not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8952","description":"Pre-htn/htn_ no f/u_ not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF0","description":"ICD-JDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD0","description":"ICD-KAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald unspecified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5274","description":"Ald unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC0","description":"ICD-FGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF1","description":"ICD-ADBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD0","description":"ICD-BBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC0","description":"ICD-LISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC1","description":"ICD-CFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE0","description":"ICD-KALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB0","description":"ICD-BIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA1","description":"ICD-CFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4216","description":"Sterile water/saline_ 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC0","description":"ICD-CALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE0","description":"ICD-BCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB0","description":"ICD-FEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE0","description":"ICD-KCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD0","description":"ICD-JHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA1","description":"ICD-OHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt inpat subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94003","description":"Vent mgmt inpat subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6531","description":"Compression stocking bk30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME0","description":"ICD-MLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1327","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7562","description":"HCPCS-C7562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4220F","description":"Digoxin thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB0","description":"ICD-OARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC0","description":"ICD-GGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC1","description":"ICD-FAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF1","description":"ICD-BIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA0","description":"ICD-OBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB1","description":"ICD-NEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA51","description":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33980","description":"Remove intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58285","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE1","description":"ICD-HGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63306","description":"Remov vert idrl bdy thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Male vacuum erection system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7900","description":"Male vacuum erection system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiotherapy dose plan imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77301","description":"Radiotherapy dose plan imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD0","description":"ICD-JDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC1","description":"ICD-KBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Miro3D_ per cu cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2025","description":"Miro3D_ per cu cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA0","description":"ICD-OFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF1","description":"ICD-OFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI STOOL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87338","description":"IAAD IA HPYLORI STOOL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD1","description":"ICD-CFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE1","description":"ICD-FACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin total transcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88720","description":"Bilirubin total transcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urofollitropin_ 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3355","description":"Urofollitropin_ 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC0","description":"ICD-DBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0926T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","description":"CPT-0926T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD1","description":"ICD-NAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36810","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC1","description":"ICD-EDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA1","description":"ICD-BDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB0","description":"ICD-CISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sealant repair per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1353","description":"Sealant repair per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC0","description":"ICD-NKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional brain mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96020","description":"Functional brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF0","description":"ICD-CCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant related per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9975","description":"Transplant related per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB1","description":"ICD-KCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA0","description":"ICD-OASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31505","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE1","description":"ICD-CIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam establish patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92012","description":"Eye exam establish patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37299","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","description":"CPT-37299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB21","description":"ICD-3CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF1","description":"ICD-GGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3357","description":"Pulpal regeneration complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD0","description":"ICD-FIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt cran bone flap to abdo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61316","description":"Implt cran bone flap to abdo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD1","description":"ICD-FECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC0","description":"ICD-EICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abx reg prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9498","description":"Abx reg prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE0","description":"ICD-NJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","description":"HCPCS-Q4384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB1","description":"ICD-BCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB1","description":"ICD-GBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB1","description":"ICD-OAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24600","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99218","description":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92642","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","description":"CPT-92642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB0","description":"ICD-KDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1200","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transport port x-ray multipl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0075","description":"Transport port x-ray multipl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9849","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC0","description":"ICD-FCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF0","description":"ICD-KIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC0","description":"ICD-MBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC0","description":"ICD-IBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD0","description":"ICD-EBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA1","description":"ICD-IDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA0","description":"ICD-MBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC114","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87530","description":"Hsv dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB0","description":"ICD-MIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC0","description":"ICD-EECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF0","description":"ICD-OALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2221","description":"Solid caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE231","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture anaerobe ident each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87076","description":"Culture anaerobe ident each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA1","description":"ICD-BDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3513F","description":"Hep b scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recomb obizur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7188","description":"Factor viii recomb obizur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Centrifuge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1500","description":"Centrifuge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1475","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","description":"HCPCS-M1475","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1110","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Septal defect imp sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1817","description":"Septal defect imp sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD1","description":"ICD-GGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE1","description":"ICD-GFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC0","description":"ICD-MAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63046","description":"Remove spine lamina 1 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE0","description":"ICD-CHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90913","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Each Additional 15 Minutes Of One-On-One Physician Or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC0","description":"ICD-EDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC11","description":"ICD-4JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC1","description":"ICD-JDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kyphectomy 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22819","description":"Kyphectomy 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indiv pdc not > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9513","description":"Indiv pdc not > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0799T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF1","description":"ICD-NCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9524","description":"I131 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB11","description":"ICD-4HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF0","description":"ICD-KGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB0","description":"ICD-PCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC0","description":"ICD-BGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0485T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44408","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD1","description":"ICD-IITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC1","description":"ICD-FBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF1","description":"ICD-JIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE0","description":"ICD-MFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC0","description":"ICD-PDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise flexor carpi radialis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25001","description":"Incise flexor carpi radialis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC0","description":"ICD-NICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syringe w/needle insulin 3cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4232","description":"Syringe w/needle insulin 3cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB0","description":"ICD-CEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB1","description":"ICD-BHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE1","description":"ICD-OCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46270","description":"Remove anal fist subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB140","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC0","description":"ICD-JBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB1","description":"ICD-CDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1104","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of carotene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82380","description":"Assay of carotene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24575","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zidovudine_ oral_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0104","description":"Zidovudine_ oral_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE1","description":"ICD-JBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF0","description":"ICD-CGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein bld hr fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83701","description":"Lipoprotein bld hr fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD0","description":"ICD-JGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC1","description":"ICD-KEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA0","description":"ICD-BBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4A","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB1","description":"ICD-NCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC1","description":"ICD-IGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0654T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF0","description":"ICD-PEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC0","description":"ICD-KBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0972","description":"Lso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA0","description":"ICD-PIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD0","description":"ICD-OBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gs mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9235","description":"Gs mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX55","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA1","description":"ICD-FBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX31","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43888","description":"Change gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC1","description":"ICD-JDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA11","description":"ICD-1LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC251","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC0","description":"ICD-ODXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD1","description":"ICD-OCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC1","description":"ICD-LISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC1","description":"ICD-IHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE0","description":"ICD-ADEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE0","description":"ICD-OKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic control thoracic ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2660","description":"Thoracic control thoracic ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED1","description":"ICD-CFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orchiopexy (fowler-stephens)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54650","description":"Orchiopexy (fowler-stephens)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Igh gene rearrang dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81262","description":"Igh gene rearrang dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0681","description":"Non-pneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC0","description":"ICD-CASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD0","description":"ICD-KARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC0","description":"ICD-PLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE0","description":"ICD-LBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC1","description":"ICD-CCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65400","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial strain imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399T","description":"Myocardial strain imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidurography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72275","description":"Epidurography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA0","description":"ICD-FGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE1","description":"ICD-IEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5144","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","description":"HCPCS-Q5144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2299","description":"Lens bifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF1","description":"ICD-OILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD1","description":"ICD-NCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54000","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB0","description":"ICD-OAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87516","description":"Hepatitis b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32251","description":"Anesth biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID1","description":"ICD-BHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD1","description":"ICD-EEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC1","description":"ICD-NABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"New episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1127F","description":"New episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC0","description":"ICD-DEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA1","description":"ICD-MAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND0","description":"ICD-NEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69100","description":"Biopsy of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0631U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0631U","description":"CPT-0631U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE1","description":"ICD-CEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0261U","description":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB1","description":"ICD-EELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray assay calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82370","description":"X-ray assay calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9219","description":"Leuprolide acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35458","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post-coital mucous exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0115","description":"Post-coital mucous exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD1","description":"ICD-CAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC1","description":"ICD-MKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam pelvic limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76857","description":"Us exam pelvic limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA1","description":"ICD-JIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC1","description":"ICD-NEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cutting ramus open w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7943","description":"Cutting ramus open w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA0","description":"ICD-EALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58290","description":"Vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee disc/dial lock/adj flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2425","description":"Knee disc/dial lock/adj flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD1","description":"ICD-IDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multidisciplinary care plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580F","description":"Multidisciplinary care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE1","description":"ICD-BHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF1","description":"ICD-KCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardioversion electric int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92961","description":"Cardioversion electric int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33418","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD1","description":"ICD-EELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded plas rig ant tib","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1945","description":"Afo molded plas rig ant tib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF1","description":"ICD-CBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA0","description":"ICD-FFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB21","description":"ICD-4AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF0","description":"ICD-HGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF0","description":"ICD-BGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA1","description":"ICD-GAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bh ltc res r&b_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2048","description":"Bh ltc res r&b_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB1","description":"ICD-OBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1434","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","description":"HCPCS-M1434","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47141","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA0","description":"ICD-BGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver & spleen image/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78216","description":"Liver & spleen image/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC0","description":"ICD-BFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87512","description":"Gardner vag dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD1","description":"ICD-GCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disconnect locking wrist uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6615","description":"Disconnect locking wrist uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF1","description":"ICD-BIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA1","description":"ICD-OBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF1","description":"ICD-BHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB1","description":"ICD-JGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA1","description":"ICD-GAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0915T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","description":"CPT-0915T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0931T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","description":"CPT-0931T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot/toes surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28899","description":"Foot/toes surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD1","description":"ICD-OGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF1","description":"ICD-KHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27516","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED1","description":"ICD-GIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA1","description":"ICD-EBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","description":"CPT-00770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA1","description":"ICD-JBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF0","description":"ICD-DIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27745","description":"Reinforce tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF0","description":"ICD-IDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA1","description":"ICD-OIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81456","description":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA1","description":"ICD-OERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant nerve end","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64787","description":"Implant nerve end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA0","description":"ICD-GCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428U","description":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36596","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9349","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB1","description":"ICD-GHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF1","description":"ICD-OLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB1","description":"ICD-FAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB1","description":"ICD-FDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB0","description":"ICD-DBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD1","description":"ICD-LDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest allogeneic stem cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38205","description":"Harvest allogeneic stem cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0664T","description":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB0","description":"ICD-ACTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Singl visn sphere 7.12-20.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2102","description":"Singl visn sphere 7.12-20.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB0","description":"ICD-CAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD0","description":"ICD-GDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB1","description":"ICD-NBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD0","description":"ICD-OGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay malate dehydrogenase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83775","description":"Assay malate dehydrogenase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC1","description":"ICD-DAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA0","description":"ICD-FHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386U","description":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9407","description":"No 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ic inf pbw 2501-5000 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99480","description":"Ic inf pbw 2501-5000 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA0","description":"ICD-MGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33897","description":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE1","description":"ICD-GBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8672","description":"Fun stat score neck/ts < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD0","description":"ICD-FICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA0","description":"ICD-DHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta not given no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9188","description":"Beta not given no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD0","description":"ICD-CAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB0","description":"ICD-IGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26118","description":"Rad resect hand tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47480","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF0","description":"ICD-EHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE1","description":"ICD-ABEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA01","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx septal fx w/wo stabj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21336","description":"Open tx septal fx w/wo stabj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99339","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3B","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF0","description":"ICD-KIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB1","description":"ICD-NEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-heu tc-99m add-on/dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9969","description":"Non-heu tc-99m add-on/dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB0","description":"ICD-OEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10121","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE1","description":"ICD-KGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC0","description":"ICD-DDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24340","description":"Repair of biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB0","description":"ICD-JBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl >=3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6615","description":"Onlay cst nbl mtl >=3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231U","description":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE0","description":"ICD-GEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lang express goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9163","description":"Lang express goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe clubfoot wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3380","description":"Shoe clubfoot wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb not rxd; doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8474","description":"Ace/arb not rxd; doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast gap flap reconst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2066","description":"Breast gap flap reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEB0","description":"ICD-MAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0138","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","description":"HCPCS-J0138","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0493U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","description":"CPT-0493U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF0","description":"ICD-FCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF1","description":"ICD-OHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA1","description":"ICD-JDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC11","description":"ICD-1EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99491","description":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE0","description":"ICD-MJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral stomach tube levine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4083","description":"Enteral stomach tube levine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molded inner boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2280","description":"Molded inner boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tun ip cath w/port","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49419","description":"Insert tun ip cath w/port","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC0","description":"ICD-OJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA0","description":"ICD-NLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX06","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67880","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8856","description":"Ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9974","description":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0776T","description":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","description":"HCPCS-M1398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6634","description":"Onlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC1","description":"ICD-KGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7007","description":"Adult electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC1","description":"ICD-ADLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alveoloplasty not w/extracts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7321","description":"Alveoloplasty not w/extracts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25526","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8A","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC0","description":"ICD-KIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27810","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9015","description":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0301","description":"CDT-D0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine pch w ex wear bar conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4393","description":"Urine pch w ex wear bar conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84233","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD0","description":"ICD-IEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine bending","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72114","description":"X-ray exam l-s spine bending","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB1","description":"ICD-KBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD0","description":"ICD-NGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC0","description":"ICD-GHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF0","description":"ICD-CBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Init nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99460","description":"Init nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB0","description":"ICD-KGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69728","description":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE1","description":"ICD-OKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioArmor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4188","description":"AmnioArmor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1A","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD0","description":"ICD-IAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99225","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1031T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1031T","description":"CPT-1031T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA1","description":"ICD-AICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC1","description":"ICD-CBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB0","description":"ICD-OLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak 4 bar link w/fric swing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5611","description":"Ak 4 bar link w/fric swing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB43","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB1","description":"ICD-HAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB11","description":"ICD-1GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procenta_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4310","description":"Procenta_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD0","description":"ICD-IHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE0","description":"ICD-HARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC1","description":"ICD-OFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND1","description":"ICD-CBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heparin neutralization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85525","description":"Heparin neutralization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB0","description":"ICD-CFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15261","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj shoulder ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1840","description":"Adj shoulder ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE1","description":"ICD-FDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB0","description":"ICD-EAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE1","description":"ICD-FITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23470","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE1","description":"ICD-DHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25920","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB1","description":"ICD-ODHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF1","description":"ICD-MBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD206","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB0","description":"ICD-ODHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2218","description":"Foam propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93593","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA0","description":"ICD-MFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID1","description":"ICD-CDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB1","description":"ICD-GBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87636","description":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB1","description":"ICD-KHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antinomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86602","description":"Antinomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria x10sv add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33258","description":"Ablate atria x10sv add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergent Cases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1142","description":"Emergent Cases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA1","description":"ICD-MJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC1","description":"ICD-OLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5246","description":"Hearing aid_ prog_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC1","description":"ICD-GIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Larynx surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31599","description":"Larynx surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF1","description":"ICD-MAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF1","description":"ICD-KCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC0","description":"ICD-OIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD0","description":"ICD-NLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA0","description":"ICD-ODVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55400","description":"Repair of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA0","description":"ICD-HBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC0","description":"ICD-ADHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC226","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB1","description":"ICD-KCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","description":"HCPCS-Q4408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95722","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC0","description":"ICD-EEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferon gamma 1-b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9216","description":"Interferon gamma 1-b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99451","description":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84586","description":"Assay of vip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd endoscopic stent place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43266","description":"Egd endoscopic stent place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home hospice case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0271","description":"Home hospice case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB0","description":"ICD-OJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD1","description":"ICD-FDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD1","description":"ICD-AAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA0","description":"ICD-DDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE0","description":"ICD-JEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451U","description":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB0","description":"ICD-NFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87389","description":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93595","description":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0901T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","description":"CPT-0901T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablation Pros Tr Hifu Incl I Guid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9747","description":"Ablation Pros Tr Hifu Incl I Guid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD1","description":"ICD-BIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1021","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0654","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","description":"HCPCS-J0654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA1","description":"ICD-OJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC1","description":"ICD-BDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC0","description":"ICD-NCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA0","description":"ICD-CINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC1","description":"ICD-AFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81373","description":"Hla i typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA0","description":"ICD-FIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation toe & metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28810","description":"Amputation toe & metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB0","description":"ICD-FIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC1","description":"ICD-OADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED0","description":"ICD-OFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE1","description":"ICD-PEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC1","description":"ICD-OHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cath repair kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5518","description":"Hit cath repair kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB155","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF0","description":"ICD-FHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","description":"CPT-64654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD0","description":"ICD-IATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68525","description":"Biopsy of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0032U","description":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB0","description":"ICD-CDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF0","description":"ICD-JITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB11","description":"ICD-3FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61619","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl devital tis 20 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97597","description":"Rmvl devital tis 20 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9170","description":"HCPCS-C9170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC0","description":"ICD-IDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE0","description":"ICD-KIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Device handling phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99002","description":"Device handling phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC1","description":"ICD-DFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA1","description":"ICD-JGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emer rspns system purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5162","description":"Emer rspns system purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47531","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa-fcab_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9332","description":"Injection_ efgartigimod alfa-fcab_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF1","description":"ICD-OLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duplicate/copy patient_s records","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9961","description":"Duplicate/copy patient_s records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE1","description":"ICD-OBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL52","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB1","description":"ICD-CIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD1","description":"ICD-NEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA1","description":"ICD-IAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49614","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66155","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0702","description":"HCPCS-C0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc death in hosp aaa repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9262","description":"Doc death in hosp aaa repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD201","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0577T","description":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB1","description":"ICD-CAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA0","description":"ICD-KFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE1","description":"ICD-BEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8X","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med abortion inc all ex drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0199","description":"Med abortion inc all ex drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE0","description":"ICD-NFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF0","description":"ICD-OHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB0","description":"ICD-KCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25635","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA1","description":"ICD-BCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin suppression panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80432","description":"Insulin suppression panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0514","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg scan w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297T","description":"Ext ecg scan w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD1","description":"ICD-LFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin suppl 100 caps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0194","description":"Vitamin suppl 100 caps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7194","description":"Factor ix complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5104","description":"HCPCS-A5104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD0","description":"ICD-IITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC1","description":"ICD-CFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42180","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC0","description":"ICD-GCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen test marrow b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3155F","description":"Cytogen test marrow b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guided tiss regen nonresorb","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4267","description":"Guided tiss regen nonresorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND1","description":"ICD-NCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE1","description":"ICD-OCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0779T","description":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61566","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF1","description":"ICD-KHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE1","description":"ICD-KAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD0","description":"ICD-FETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wc van mileage per mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0209","description":"Wc van mileage per mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD0","description":"ICD-FFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spectinomycn di-hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3320","description":"Spectinomycn di-hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF0","description":"ICD-GFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9246","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9246","description":"CDT-D9246","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pch bar w lock fln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4433","description":"Urine ost pch bar w lock fln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16374","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16374","description":"CPT-16374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC1","description":"ICD-NCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20972","description":"Bone/skin graft metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB0","description":"ICD-BFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED0","description":"ICD-NLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA1","description":"ICD-IBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cbt each addl hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94645","description":"Cbt each addl hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC0","description":"ICD-FBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23180","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC1","description":"ICD-AGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF0","description":"ICD-MCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB21","description":"ICD-4HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25365","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE0","description":"ICD-IETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 40 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1030","description":"Methylprednisolone 40 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0D","description":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE115","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other carot sten 120 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9007F","description":"Other carot sten 120 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE0","description":"ICD-CDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF1","description":"ICD-NBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB1","description":"ICD-LEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9563","description":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC0","description":"ICD-AITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD1","description":"ICD-BGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME1","description":"ICD-KHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB1","description":"ICD-GAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel face dermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15789","description":"Chemical peel face dermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB0","description":"ICD-FBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Helicoll_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4164","description":"Helicoll_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF1","description":"ICD-NIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA34","description":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE130","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96116","description":"Neurobehavioral status exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75710","description":"Artery x-rays arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad exp time w/o fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9501","description":"Rad exp time w/o fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","description":"HCPCS-Q4395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC0","description":"ICD-FHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA1","description":"ICD-KHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB1","description":"ICD-IBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection eye drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67028","description":"Injection eye drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC1","description":"ICD-ACAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA1","description":"ICD-OGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA0","description":"ICD-OJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC0","description":"ICD-MCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reattach tooth fragment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2921","description":"Reattach tooth fragment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30435","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB1","description":"ICD-AIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lamination collar w/ couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6629","description":"Lamination collar w/ couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB1","description":"ICD-JFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA1","description":"ICD-GIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63196","description":"Incise spine&cord 2 trx crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE1","description":"ICD-KEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF1","description":"ICD-JGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14851","description":"Anesth eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin respon genetic test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9143","description":"Warfarin respon genetic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD0","description":"ICD-CIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion insulin pump needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4231","description":"Infusion insulin pump needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1653","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","description":"HCPCS-L1653","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron mesylate oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0180","description":"Dolasetron mesylate oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA0","description":"ICD-NFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE0","description":"ICD-ODKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF0","description":"ICD-NALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB0","description":"ICD-JEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1098T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1098T","description":"CPT-1098T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27615","description":"Resect leg/ankle tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC12","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID0","description":"ICD-OGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22100","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted ambulance service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0999","description":"Unlisted ambulance service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD1","description":"ICD-KHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD236","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB1","description":"ICD-FFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantable/insertable device for device intensive procedure_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1889","description":"Implantable/insertable device for device intensive procedure_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE1","description":"ICD-JHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0504","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA0","description":"ICD-GBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES150","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric p r1-r2noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9101","description":"Onc dx gastric p r1-r2noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA0","description":"ICD-JETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43756","description":"Dx duod intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA31","description":"ICD-4GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophag t1-t3 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9096","description":"Onc dx esophag t1-t3 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF0","description":"ICD-KCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66020","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sheath above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8410","description":"Sheath above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE1","description":"ICD-EDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press chinstrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7036","description":"Pos airway press chinstrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3763F","description":"Patient is not dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admission to mccm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9480","description":"Admission to mccm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA0","description":"ICD-NFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66172","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1456","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","description":"HCPCS-M1456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4038","description":"Vascular Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0904","description":"HCPCS-B0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD210","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hzv vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90736","description":"Hzv vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB1","description":"ICD-MFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5909","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5909","description":"CDT-D5909","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smokeless tobacco user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1035F","description":"Smokeless tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB0","description":"ICD-GHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo assay seven anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81506","description":"Endo assay seven anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0854T","description":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC1","description":"ICD-KIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD0","description":"ICD-KBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE0","description":"ICD-GIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural l/s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64483","description":"Inj foramen epidural l/s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0530","description":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF0","description":"ICD-BICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB0","description":"ICD-GDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80303","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2013","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA0","description":"ICD-GAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9325","description":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert levonorgestrel ius","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4981","description":"Insert levonorgestrel ius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179T","description":"64 lead ecg w/tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93243","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF0","description":"ICD-KCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC0","description":"ICD-ABAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmptr ophth img optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92133","description":"Cmptr ophth img optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise max/zygoma b9 tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21030","description":"Excise max/zygoma b9 tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86849","description":"Immunology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME0","description":"ICD-JIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61641","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF0","description":"ICD-GACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control band & belt b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2640","description":"Pelvic control band & belt b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA0","description":"ICD-GCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC1","description":"ICD-HCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lysis + lavage w catheters","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7871","description":"Lysis + lavage w catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA0","description":"ICD-OLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA12","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB0","description":"ICD-KIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33978","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr); Following Liquid Enrichment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA0","description":"ICD-BHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36906","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA0","description":"ICD-PGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC1","description":"ICD-BGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoluminal bx biliary tree","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47543","description":"Endoluminal bx biliary tree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00908","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","description":"CPT-00908","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC1","description":"ICD-GAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD1","description":"ICD-METD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93245","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","description":"HCPCS-Q4387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise tendon(s) & muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23406","description":"Incise tendon(s) & muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc no pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1151F","description":"Doc no pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE0","description":"ICD-AHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB1","description":"ICD-KFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2619","description":"Pmkr_ dual_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abdom w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74175","description":"Ct angio abdom w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC1","description":"ICD-FIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2506","description":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent bran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9601","description":"Perc drug-el cor stent bran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB0","description":"ICD-IHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hh aide or cn aide per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1021","description":"Hh aide or cn aide per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA1","description":"ICD-FHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2074","description":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","description":"CPT-55713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF1","description":"ICD-GHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lifts elevation heel /i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3334","description":"Shoe lifts elevation heel /i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB24","description":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL07","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF0","description":"ICD-MKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC1","description":"ICD-IGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA0","description":"ICD-JGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE1","description":"ICD-NDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas non-cardiac abl cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1888","description":"Endovas non-cardiac abl cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27381","description":"Repair/graft kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF1","description":"ICD-NAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC1","description":"ICD-IHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0635","description":"Patient lift electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE1","description":"ICD-OINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB0","description":"ICD-EHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB34","description":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0802T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9232","description":"HCPCS-J9232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC0","description":"ICD-FIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF0","description":"ICD-NFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28011","description":"Incision of toe tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA220","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6216","description":"Non-sterile gauze<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE112","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC1","description":"ICD-FCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB1","description":"ICD-GGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE1","description":"ICD-FEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1481","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","description":"HCPCS-M1481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52700","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove contraceptive capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11976","description":"Remove contraceptive capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE0","description":"ICD-BIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epiglottis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31420","description":"Removal of epiglottis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Internal nerve revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64727","description":"Internal nerve revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC0","description":"ICD-OLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF0","description":"ICD-MEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA0","description":"ICD-GBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0512T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC0","description":"ICD-NCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD0","description":"ICD-ODVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21433","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA1","description":"ICD-OFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hpv high-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87624","description":"Hpv high-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC0","description":"ICD-OCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35091","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA0","description":"ICD-CHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay phosphohexose enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84087","description":"Assay phosphohexose enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g benzathine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0561","description":"Penicillin g benzathine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB0","description":"ICD-GAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC0","description":"ICD-GEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA12","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lomustine 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0178","description":"Lomustine 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD0","description":"ICD-JDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC0","description":"ICD-NAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9479","description":"Pharmacist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF1","description":"ICD-BATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE0","description":"ICD-OFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC0","description":"ICD-OCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8D","description":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE0","description":"ICD-KCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7299","description":"Removal of temporary anchorage device_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1019T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","description":"CPT-1019T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0879","description":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C-reactive protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86140","description":"C-reactive protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC0","description":"ICD-OAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pelvis contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58240","description":"Removal of pelvis contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen non tlc devices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80300","description":"Drug screen non tlc devices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB0","description":"ICD-LFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE0","description":"ICD-FIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC0","description":"ICD-FBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA0","description":"ICD-OHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2216","description":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51784","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1886","description":"Catheter_ ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA1","description":"ICD-KGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dimethadione","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6048","description":"Dimethadione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD1","description":"ICD-FCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB1","description":"ICD-GHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF0","description":"ICD-MIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zaire ebolavirus vaccine_ live_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90758","description":"Zaire ebolavirus vaccine_ live_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB0","description":"ICD-JEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebase hybrid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5725","description":"Rebase hybrid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42815","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA1","description":"ICD-JIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF0","description":"ICD-IAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1600","description":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC0","description":"ICD-GDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic aneurysm<5cm diam ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9001F","description":"Aortic aneurysm<5cm diam ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76831","description":"Echo exam uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pegloticase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2507","description":"Pegloticase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC36","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0070","description":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD0","description":"ICD-BEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA1","description":"ICD-CGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD0","description":"ICD-KBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0010","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE0","description":"ICD-PCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA0","description":"ICD-CIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA0","description":"ICD-LHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME1","description":"ICD-BDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA1","description":"ICD-JGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mitochondrial Antibody (Eg_ M2)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86381","description":"Mitochondrial Antibody (Eg_ M2)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11303","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intrpulmnry percuss vent sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0481","description":"Intrpulmnry percuss vent sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lev 4 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0383","description":"Lev 4 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mntr io press 24hrs/> uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329T","description":"Mntr io press 24hrs/> uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bifoc prscp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0506","description":"Bifoc prscp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81326","description":"Pmp22 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe wedge sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3340","description":"Shoe wedge sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0784T","description":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA22","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD0","description":"ICD-JEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE1","description":"ICD-KADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE0","description":"ICD-AABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE1","description":"ICD-CFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF0","description":"ICD-KAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC224","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC0","description":"ICD-OGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9624","description":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts not don","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8674","description":"Fun stat scor nek/ts not don","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD0","description":"ICD-CAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB1","description":"ICD-CDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE1","description":"ICD-IBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB1","description":"ICD-BAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB0","description":"ICD-EDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC1","description":"ICD-MJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8H","description":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB1","description":"ICD-PBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1116","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC140","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81230","description":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8I","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF1","description":"ICD-MBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB0","description":"ICD-KHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plnning pt spec fenest graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34839","description":"Plnning pt spec fenest graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ziprasidone mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3486","description":"Ziprasidone mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C/o for orthotic/prosth use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97762","description":"C/o for orthotic/prosth use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF0","description":"ICD-CAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66850","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB130","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF1","description":"ICD-PCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wash harvest stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38209","description":"Wash harvest stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB1","description":"ICD-BAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7558","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvest femoropopliteal vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35572","description":"Harvest femoropopliteal vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC115","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72190","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE0","description":"ICD-KENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE0","description":"ICD-OANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB1","description":"ICD-JITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB0","description":"ICD-NHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC0","description":"ICD-MFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26140","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA1","description":"ICD-IALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC1","description":"ICD-BBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB1","description":"ICD-JCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB0","description":"ICD-AFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC0","description":"ICD-CFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC0","description":"ICD-FINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE1","description":"ICD-KDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB0","description":"ICD-OIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23474","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4613","description":"Battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD0","description":"ICD-FHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool tub_ walk-in_ portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1301","description":"Whirlpool tub_ walk-in_ portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HER2/neu negative or undocumented/unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9825","description":"HER2/neu negative or undocumented/unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment chinstrp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6502","description":"Compres burngarment chinstrp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0884","description":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC0","description":"ICD-DISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aluminum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82108","description":"Assay of aluminum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB1","description":"ICD-KDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC0","description":"ICD-JHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthro_ loose body + chondro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0289","description":"Arthro_ loose body + chondro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF1","description":"ICD-NJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD1","description":"ICD-IHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release inner ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69960","description":"Release inner ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF0","description":"ICD-GBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC1","description":"ICD-FFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE1","description":"ICD-LBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo mech stance ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5716","description":"Knee-shin exo mech stance ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC1","description":"ICD-OKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25600","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA0","description":"ICD-GDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356U","description":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD1","description":"ICD-OASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69552","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD0","description":"ICD-ICUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA11","description":"ICD-3DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA221","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15822","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC1","description":"ICD-OIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD0","description":"ICD-JHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Edetate disodium per 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3520","description":"Edetate disodium per 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE0","description":"ICD-GCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90669","description":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0693U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693U","description":"CPT-0693U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA0","description":"ICD-CIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE0","description":"ICD-GDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD0","description":"ICD-ACTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA0","description":"ICD-LGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Island pedicle flap graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15740","description":"Island pedicle flap graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD251","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electric current therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97033","description":"Electric current therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp mal+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11620","description":"Exc h-f-nk-sp mal+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8657","description":"Fun stat score le pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA0","description":"ICD-FBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45110","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg cong cyst malf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2402","description":"Fetal surg cong cyst malf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC0","description":"ICD-GCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad sleeve heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8423","description":"Custom grad sleeve heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81109","description":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1705","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1705","description":"CDT-D1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99192","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobility goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8979","description":"Mobility goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD0","description":"ICD-KHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61210","description":"Pierce skull implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID1","description":"ICD-CBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC0","description":"ICD-GABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA126","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF0","description":"ICD-NDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0502U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","description":"CPT-0502U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12021","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA1","description":"ICD-MCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28020","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA0","description":"ICD-GHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28456","description":"Treat midfoot fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0011","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5B","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD0","description":"ICD-GAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44150","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration popliteal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35741","description":"Exploration popliteal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA0","description":"ICD-IBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA1","description":"ICD-IDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF1","description":"ICD-CGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD0","description":"ICD-OLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE1","description":"ICD-OBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB1","description":"ICD-NKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11623","description":"Exc s/n/h/f/g mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38745","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of thigh muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27430","description":"Revision of thigh muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF0","description":"ICD-GBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE0","description":"ICD-GFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE1","description":"ICD-DEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97110","description":"Therapeutic exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA1","description":"ICD-OLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4211","description":"Gingivectomy/plasty per toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377U","description":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC0","description":"ICD-KIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND0","description":"ICD-GBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF1","description":"ICD-NJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90706","description":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0803","description":"HCPCS-C0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome karyotype study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88280","description":"Chromosome karyotype study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect face/scalp tum < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21015","description":"Resect face/scalp tum < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc renal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234T","description":"Trluml perip athrc renal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test panel pricing code_ 22+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP22","description":"Auto.test panel pricing code_ 22+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA0","description":"ICD-ECHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB1","description":"ICD-FAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE1","description":"ICD-IHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0921T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","description":"CPT-0921T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND0","description":"ICD-FDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraut copper contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7300","description":"Intraut copper contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval appros surg thxpy epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5200F","description":"Eval appros surg thxpy epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psych diagnostic evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90791","description":"Psych diagnostic evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk molded supracondylar susp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5670","description":"Bk molded supracondylar susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB1","description":"ICD-CAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71030","description":"Chest x-ray 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92518","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF0","description":"ICD-CIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj bulking agent anal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8605","description":"Inj bulking agent anal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA0","description":"ICD-LIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC1","description":"ICD-JCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD1","description":"ICD-GGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE0","description":"ICD-JECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB1","description":"ICD-CGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC0","description":"ICD-OCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21208","description":"Augmentation of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD1","description":"ICD-MIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27235","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE0","description":"ICD-NFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av fistula revision open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36832","description":"Av fistula revision open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec knee-shin swing/stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5856","description":"Elec knee-shin swing/stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Max sterile barriers flwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6030F","description":"Max sterile barriers flwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB151","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA0","description":"ICD-AEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF1","description":"ICD-IAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF0","description":"ICD-NLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise head/neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27179","description":"Revise head/neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC1","description":"ICD-GGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC1","description":"ICD-GHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE0","description":"ICD-PLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB0","description":"ICD-CFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD0","description":"ICD-OCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE1","description":"ICD-OFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD0","description":"ICD-FHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC1","description":"ICD-JEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF0","description":"ICD-EILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE0","description":"ICD-HHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp recip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290T","description":"Laser inc for pkp/lkp recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1055T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1055T","description":"CPT-1055T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC1","description":"ICD-KETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise low back nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64714","description":"Revise low back nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3357","description":"Ustekinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA0","description":"ICD-KBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF1","description":"ICD-NEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA1","description":"ICD-GDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA0","description":"ICD-BGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Great toe-hand transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26551","description":"Great toe-hand transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC151","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing serologic abo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86900","description":"Blood typing serologic abo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD0","description":"ICD-OGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peridontal medicament","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5994","description":"Peridontal medicament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB21","description":"ICD-2CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7556","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA1","description":"ICD-OGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/ coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4561F","description":"Pt w/ coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB1","description":"ICD-BHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine Administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031A","description":"Janssen Covid-19 Vaccine Administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE0","description":"ICD-KAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE0","description":"ICD-PKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB1","description":"ICD-CIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC1","description":"ICD-GCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB1","description":"ICD-OHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0203","description":"HCPCS-C0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD0","description":"ICD-BBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB1","description":"ICD-EAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC0","description":"ICD-HDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD1","description":"ICD-PGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC1","description":"ICD-FANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0874","description":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC0","description":"ICD-HDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE0","description":"ICD-NJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD0","description":"ICD-CAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA0","description":"ICD-PHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF0","description":"ICD-NCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF0","description":"ICD-EDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD1","description":"ICD-MELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB0","description":"ICD-GDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mibm but no dx of breast ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8946","description":"Mibm but no dx of breast ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap ablat uterine fibroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336T","description":"Lap ablat uterine fibroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stationary liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0439","description":"Stationary liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC1","description":"ICD-GIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88130","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46735","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD0","description":"ICD-EGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1738","description":"Injection_ meloxicam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy salpingostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58673","description":"Laparoscopy salpingostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete aa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4303","description":"Complete aa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42220","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low-level laser trmt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8948","description":"Low-level laser trmt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ca screen;flexi sigmoidscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0104","description":"Ca screen;flexi sigmoidscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD1","description":"ICD-KCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD1","description":"ICD-PHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF0","description":"ICD-ODXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB0","description":"ICD-CHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE0","description":"ICD-MKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22842","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA0","description":"ICD-MDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","description":"HCPCS-E1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC0","description":"ICD-BHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD0","description":"ICD-NEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB05","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remis 12m phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9509","description":"Remis 12m phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF1","description":"ICD-FATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA1","description":"ICD-BETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81107","description":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE1","description":"ICD-OGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA0","description":"ICD-LBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB1","description":"ICD-EHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC1","description":"ICD-KERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL13","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93312","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23170","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC0","description":"ICD-OGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20922","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA0","description":"ICD-JHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE0","description":"ICD-OBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26670","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA1","description":"ICD-OARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25545","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB1","description":"ICD-FCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59140","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1310","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87486","description":"Chylmd pneum dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC1","description":"ICD-GBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF0","description":"ICD-FIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0414","description":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE1","description":"ICD-BAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA1","description":"ICD-AHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8627","description":"Surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0013","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81401","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD1","description":"ICD-KHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA0","description":"ICD-GIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivacaine (posimir)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9144","description":"Injection_ bupivacaine (posimir)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7037","description":"Pos airway pressure tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF1","description":"ICD-JENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5145","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","description":"HCPCS-Q5145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE1","description":"ICD-JBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF0","description":"ICD-AAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB1","description":"ICD-NBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE205","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA0","description":"ICD-HCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26110","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA1","description":"ICD-GDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF1","description":"ICD-NGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infus each addl seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96417","description":"Chemo iv infus each addl seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect enlarged toe tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28340","description":"Resect enlarged toe tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB10","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonmed family planning ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1010","description":"Nonmed family planning ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB0","description":"ICD-FDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1874","description":"Stent_ coated/cov w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration carotid artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35701","description":"Exploration carotid artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC0","description":"ICD-CHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD0","description":"ICD-CHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive ear canal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69150","description":"Extensive ear canal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25400","description":"Repair radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE1","description":"ICD-IHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD1","description":"ICD-PAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC1","description":"ICD-ODPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWC1","description":"ICD-CCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replc tth&acrlc on mtl frmwk","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5670","description":"Replc tth&acrlc on mtl frmwk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE0","description":"ICD-EBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390U","description":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus augmentation vertical","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7952","description":"Sinus augmentation vertical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC1","description":"ICD-PEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE0","description":"ICD-KHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33414","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE212","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No ster wd ifx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8572","description":"No ster wd ifx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB0","description":"ICD-LIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vert bitewings-sev to eight","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0277","description":"Vert bitewings-sev to eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE1","description":"ICD-NKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA11","description":"ICD-4DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual ep acuity screen auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333T","description":"Visual ep acuity screen auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD1","description":"ICD-MGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB1","description":"ICD-FCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA0","description":"ICD-ADBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE1","description":"ICD-BDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96202","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES346","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF1","description":"ICD-IAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA1","description":"ICD-OCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID1","description":"ICD-ODID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB1","description":"ICD-MLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF0","description":"ICD-MLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD1","description":"ICD-OEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB1","description":"ICD-KEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA0","description":"ICD-BABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD1","description":"ICD-BDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC35","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD1","description":"ICD-MLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plan caremng angnl symptdocd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557F","description":"Plan caremng angnl symptdocd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA35","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF0","description":"ICD-BAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eia hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0432","description":"Eia hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA0","description":"ICD-AGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE0","description":"ICD-FAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9943","description":"Occlusal guard adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair with fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0163","description":"Commode chair with fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB1","description":"ICD-AFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compre audiometry evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212T","description":"Compre audiometry evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1321","description":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4040","description":"Cast sup shrt leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c dpth 22-25 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2343","description":"W/c dpth 22-25 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endocerv curettage w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57456","description":"Endocerv curettage w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardioassist external","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92971","description":"Cardioassist external","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC0","description":"ICD-OKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA0","description":"ICD-NELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","description":"HCPCS-E0743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF0","description":"ICD-BDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9172","description":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB1","description":"ICD-GIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC0","description":"ICD-KIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD0","description":"ICD-CBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE1","description":"ICD-BGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE0","description":"ICD-KEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC1","description":"ICD-GISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc recpt counsl vit d/calc+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4019F","description":"Doc recpt counsl vit d/calc+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Talk pt/crgvr re areds prev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4177F","description":"Talk pt/crgvr re areds prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD221","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC0","description":"ICD-OGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF1","description":"ICD-CHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hot/cold h2obot/cap/col/wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9273","description":"Hot/cold h2obot/cap/col/wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD1","description":"ICD-BIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB0","description":"ICD-KBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF1","description":"ICD-IEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87541","description":"Legion pneumo dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth face/skull bone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19051","description":"Anesth face/skull bone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE1","description":"ICD-BFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57280","description":"Suspension of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26600","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE105","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: occipital headache in children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2195","description":"Patients with clinical indications for imaging of the head: occipital headache in children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF1","description":"ICD-IGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1023","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1023","description":"HCPCS-E1023","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC1","description":"ICD-KDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00797","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","description":"CPT-00797","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE0","description":"ICD-FDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE0","description":"ICD-AAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial open end","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5585","description":"Prep ak ischial open end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1107","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC0","description":"ICD-LDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE0","description":"ICD-FEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5A","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA0","description":"ICD-FHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME1","description":"ICD-KEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE254","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398U","description":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE1","description":"ICD-KIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF1","description":"ICD-JAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC1","description":"ICD-OJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB0","description":"ICD-JEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore treat shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23107","description":"Explore treat shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA0","description":"ICD-CESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1848","description":"Ko dbl upright w/air pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4A","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA1","description":"ICD-OJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD1","description":"ICD-AFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED0","description":"ICD-OBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB1","description":"ICD-ICCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC0","description":"ICD-IDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5B","description":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0823T","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1003","description":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded to pt silicone s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3251","description":"Shoe molded to pt silicone s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","description":"CPT-55868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27825","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99220","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26675","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE0","description":"ICD-BBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270T","description":"Rev/remvl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC1","description":"ICD-JBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA0","description":"ICD-KIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME1","description":"ICD-BFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC0","description":"ICD-GEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND1","description":"ICD-GHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE0","description":"ICD-EEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0889T","description":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE0","description":"ICD-JBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Canakinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0638","description":"Canakinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD1","description":"ICD-OJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC121","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC0","description":"ICD-BDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90964","description":"Esrd home pt serv p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6505","description":"Cmprsburngarment glove-elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal sinus therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30210","description":"Nasal sinus therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB1","description":"ICD-PAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Modification diabetic shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5507","description":"Modification diabetic shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ ippe or awv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0468","description":"Fqhc visit_ ippe or awv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA0","description":"ICD-JBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina wall complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57110","description":"Remove vagina wall complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC0","description":"ICD-CFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx 9 remiss <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9393","description":"Ini phq9 >9 remiss <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB0","description":"ICD-CGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA0","description":"ICD-AHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symes type ptb brim design s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5632","description":"Symes type ptb brim design s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD0","description":"ICD-NFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue jaw & neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41155","description":"Tongue jaw & neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE0","description":"ICD-HEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA1","description":"ICD-FBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA11","description":"ICD-1CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA1","description":"ICD-PGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA0","description":"ICD-BGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE1","description":"ICD-GFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Discography cerv/thor spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72285","description":"Discography cerv/thor spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD0","description":"ICD-LDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF0","description":"ICD-OFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","description":"CPT-00500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0476U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","description":"CPT-0476U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0084","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9604","description":"Perc d-e cor revasc t cabg s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2058","description":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422U","description":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB0","description":"ICD-CHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47147","description":"Prep donor liver/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF1","description":"ICD-PEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Talymed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4127","description":"Talymed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntiol category 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1005","description":"Ntiol category 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19283","description":"Perq dev breast 1st strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mild-mod dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3353F","description":"Mild-mod dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was a permanent nursing home resident at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1058","description":"Patient was a permanent nursing home resident at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB0","description":"ICD-BHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB0","description":"ICD-NAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA1","description":"ICD-GBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91451","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC1","description":"ICD-BEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grade 2 or above diarrhea and/or grade 2 or above colitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1181","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61867","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC1","description":"ICD-FHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol (ethanol); any specimen except breath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6040","description":"Alcohol (ethanol); any specimen except breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND0","description":"ICD-OHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros md in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8509","description":"Trach-esoph voice pros md in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap enterolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44180","description":"Lap enterolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA0","description":"ICD-KGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8696","description":"Repair Of Orthodontic Appliance - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1295","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","description":"HCPCS-M1396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB1","description":"ICD-GBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1C","description":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB0","description":"ICD-ECTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD1","description":"ICD-CBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00540","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","description":"CPT-00540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8E","description":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF1","description":"ICD-KFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB1","description":"ICD-OIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapy exercise joint rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4018F","description":"Therapy exercise joint rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA1","description":"ICD-OBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC1","description":"ICD-GBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB1","description":"ICD-FCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect clavicle tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23200","description":"Resect clavicle tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF0","description":"ICD-EIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC0","description":"ICD-OKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig full-dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90384","description":"Rh ig full-dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5281","description":"Removable partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1084T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1084T","description":"CPT-1084T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML13","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA0","description":"ICD-JDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA0","description":"ICD-KHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF1","description":"ICD-KEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF0","description":"ICD-KDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC1","description":"ICD-OEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD0","description":"ICD-CBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB1","description":"ICD-ODNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81445","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5283","description":"Removable unilateral partial denture - one piece cast metal_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33775","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA1","description":"ICD-CAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35471","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sedative hypnotics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80368","description":"Sedative hypnotics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4287","description":"Dermabind dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC0","description":"ICD-GGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB1","description":"ICD-PBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD0","description":"ICD-IICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME0","description":"ICD-JBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC0","description":"ICD-AGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC0","description":"ICD-OGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0630U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","description":"CPT-0630U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cover eye w/membrane suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65779","description":"Cover eye w/membrane suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ft insert ucb berkeley shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3000","description":"Ft insert ucb berkeley shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft peri each addl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3429","description":"Bone graft peri each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC1","description":"ICD-CGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD0","description":"ICD-KABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abdom aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75953","description":"Abdom aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME0","description":"ICD-JDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC0","description":"ICD-IFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD1","description":"ICD-KAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE1","description":"ICD-OKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC0","description":"ICD-EFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA1","description":"ICD-NEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef incomplete/modular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4155","description":"Ef incomplete/modular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA1","description":"ICD-OKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB0","description":"ICD-OICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB11","description":"ICD-3IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93280","description":"Pm device progr eval dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7638","description":"Dexamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB11","description":"ICD-2EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp multiplane ext fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20696","description":"Comp multiplane ext fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD0","description":"ICD-BETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD1","description":"ICD-OIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF1","description":"ICD-GBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78466","description":"Heart infarct image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB1","description":"ICD-DAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE1","description":"ICD-OKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF0","description":"ICD-CDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE1","description":"ICD-GGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD0","description":"ICD-LIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA05","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE1","description":"ICD-JDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27147","description":"Revision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC1","description":"ICD-FDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF0","description":"ICD-BANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","description":"CPT-90482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81293","description":"Mlh1 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC235","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB1","description":"ICD-OAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME1","description":"ICD-OCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air ambulanc nonemerg fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9960","description":"Air ambulanc nonemerg fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF0","description":"ICD-PHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80190","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF1","description":"ICD-FHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ria nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83519","description":"Ria nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0106","description":"HCPCS-B0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC0","description":"ICD-LIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27552","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9935","description":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appliance removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7997","description":"Appliance removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB0","description":"ICD-LFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD0","description":"ICD-ODPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9244","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9244","description":"CDT-D9244","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC0","description":"ICD-OADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4010","description":"Cast sup sht arm adult fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC0","description":"ICD-KFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA1","description":"ICD-PIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD0","description":"ICD-NFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acesso dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4293","description":"Acesso dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft 3/> segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35683","description":"Composite byp grft 3/> segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD1","description":"ICD-KBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0687U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687U","description":"CPT-0687U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE1","description":"ICD-DBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9033","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add tooth to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5650","description":"Add tooth to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC1","description":"ICD-FGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC0","description":"ICD-LGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD1","description":"ICD-HDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5054","description":"Clsd ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC1","description":"ICD-JAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF0","description":"ICD-GESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28024","description":"Exploration of toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE217","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1160","description":"Wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73520","description":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB1","description":"ICD-OASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_fixed_peel-away","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1892","description":"Intro/sheath_fixed_peel-away","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE0","description":"ICD-KESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0667","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","description":"HCPCS-G0667","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF0","description":"ICD-JDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD0","description":"ICD-MIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23100","description":"Biopsy of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB0","description":"ICD-DGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8544","description":"Cabg measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dstry eye lesn_fdr vssl tech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0186","description":"Dstry eye lesn_fdr vssl tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF0","description":"ICD-MEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8A","description":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF1","description":"ICD-CFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD1","description":"ICD-AHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1495","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","description":"HCPCS-M1495","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB1","description":"ICD-FADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90474","description":"Immune admin oral/nasal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE1","description":"ICD-ECIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6534","description":"Gc stocking thighlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0490U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","description":"CPT-0490U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0698T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF1","description":"ICD-CAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7207","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB53","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB24","description":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD0","description":"ICD-KGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","description":"HCPCS-Q4389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC1","description":"ICD-HFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiviral ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9245","description":"Antiviral ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB0","description":"ICD-OBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc rectal tumor endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184T","description":"Exc rectal tumor endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF1","description":"ICD-NHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA1","description":"ICD-CGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap gastric bypass/roux-en-y","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43644","description":"Lap gastric bypass/roux-en-y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add mech leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1009","description":"Add mech leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF1","description":"ICD-GDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","description":"HCPCS-Q4401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73501","description":"X-ray exam hip uni 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC07","description":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF0","description":"ICD-OAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB0","description":"ICD-CDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB1","description":"ICD-GGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB1","description":"ICD-GCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA1","description":"ICD-EHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB0","description":"ICD-CGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE0","description":"ICD-KDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac guide differs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9062","description":"Onc prac guide differs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD0","description":"ICD-CIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB1","description":"ICD-OHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND1","description":"ICD-CIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD1","description":"ICD-BCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA1","description":"ICD-PJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF1","description":"ICD-GBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433U","description":"Oncology (prostate)_ 5 DNA regulatory markers by quantitative PCR_ whole blood_ algorithm_ including prostate-specific antigen_ reported as likelihood of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF1","description":"ICD-DBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26500","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neostigmine methylslfte inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2710","description":"Neostigmine methylslfte inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD1","description":"ICD-EACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE0","description":"ICD-KHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0136U","description":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Car seat/bed test 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94780","description":"Car seat/bed test 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE1","description":"ICD-GEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE1","description":"ICD-JEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00880","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","description":"CPT-00880","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34709","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC112","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA0","description":"ICD-CDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1144","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","description":"HCPCS-Q9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF1","description":"ICD-JAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA0","description":"ICD-NDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye muscle evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92265","description":"Eye muscle evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA0","description":"ICD-NJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal hysteresis deter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92145","description":"Corneal hysteresis deter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD0","description":"ICD-LBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55899","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF0","description":"ICD-JIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB1","description":"ICD-CDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak sleeve susp neoprene/equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5695","description":"Ak sleeve susp neoprene/equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB0","description":"ICD-KHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC31","description":"ICD-4CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC1","description":"ICD-AGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB0","description":"ICD-KEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL20","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride infected skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11000","description":"Debride infected skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G9871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","description":"HCPCS-G9871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB0","description":"ICD-CFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA0","description":"ICD-EGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD206","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA1","description":"ICD-AEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF1","description":"ICD-JCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38530","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC1","description":"ICD-GFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles multifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92342","description":"Fit spectacles multifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD105","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF0","description":"ICD-EHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC1","description":"ICD-OJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95927","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 20 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP20","description":"Auto test panel pricing code_ 20 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE0","description":"ICD-MCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB1","description":"ICD-NCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC0","description":"ICD-BFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient died prior to the end of the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1060","description":"Patient died prior to the end of the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB1","description":"ICD-GEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9490","description":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5122","description":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0738","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA1","description":"ICD-EBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug delivery system <=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4306","description":"Drug delivery system <=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA1","description":"ICD-JGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA0","description":"ICD-CISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0839","description":"Pwc gp2 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ intra echocardiography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1759","description":"Cath_ intra echocardiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB1","description":"ICD-MHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE1","description":"ICD-CBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467T","description":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA1","description":"ICD-KFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3D","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB1","description":"ICD-MKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod compres band w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6451","description":"Mod compres band w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1102","description":"HCPCS-B1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB0","description":"ICD-CIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE0","description":"ICD-JABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD1","description":"ICD-NEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA1","description":"ICD-OEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC11","description":"ICD-4HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Utility services waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2035","description":"Utility services waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ isatuximab-irfc_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9227","description":"Injection_ isatuximab-irfc_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD1","description":"ICD-BCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE1","description":"ICD-HCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/treat lung lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32141","description":"Remove/treat lung lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7518","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA0","description":"ICD-AGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gen_ neuro_ non-hf rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1820","description":"Gen_ neuro_ non-hf rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE0","description":"ICD-KFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29824","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC1","description":"ICD-JHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1089U","description":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA1","description":"ICD-BATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF0","description":"ICD-JGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0050","description":"Alcohol/drug service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peritoneal lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49084","description":"Peritoneal lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB0","description":"ICD-KEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC1","description":"ICD-BGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx septal&nose fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21337","description":"Closed tx septal&nose fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device eval progr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93285","description":"Ilr device eval progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIA1","description":"ICD-NAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC1","description":"ICD-GBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE1","description":"ICD-KHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF0","description":"ICD-BIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD0","description":"ICD-NHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC0","description":"ICD-KIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA1","description":"ICD-MEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20225","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture tiss condtin mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5851","description":"Denture tiss condtin mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0596U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","description":"CPT-0596U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC0","description":"ICD-BCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB0","description":"ICD-CHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA1","description":"ICD-JCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF1","description":"ICD-NHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB1","description":"ICD-FEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pland chemo docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519F","description":"Pland chemo docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC0","description":"ICD-GIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC0","description":"ICD-LAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND0","description":"ICD-GEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE1","description":"ICD-OHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD1","description":"ICD-HASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF1","description":"ICD-NFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm isolation simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89260","description":"Sperm isolation simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA0","description":"ICD-NBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tob non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9459","description":"Tob non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC0","description":"ICD-KCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB1","description":"ICD-OKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB0","description":"ICD-GHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD1","description":"ICD-FHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intragastric hypothermia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0100","description":"Intragastric hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC1","description":"ICD-IHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110U","description":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33602","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99205","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD0","description":"ICD-IBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7524","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7524","description":"HCPCS-J7524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF0","description":"ICD-OBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE1","description":"ICD-NDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid lined custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0482","description":"Tlso rigid lined custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nontherm electromgntc device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0761","description":"Nontherm electromgntc device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC1","description":"ICD-NEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE1","description":"ICD-OKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHB0","description":"ICD-MJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB1","description":"ICD-NHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF0","description":"ICD-GCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic belt/harness/boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0944","description":"Pelvic belt/harness/boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD1","description":"ICD-CFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474U","description":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1260","description":"Dolasetron mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF0","description":"ICD-AFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB1","description":"ICD-BENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69420","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB0","description":"ICD-JEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Puraply_ puraply antimic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9349","description":"Puraply_ puraply antimic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE1","description":"ICD-IGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36904","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0618","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","description":"HCPCS-J0618","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF0","description":"ICD-GHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test for chlorohydrocarbons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82441","description":"Test for chlorohydrocarbons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE0","description":"ICD-AIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00906","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","description":"CPT-00906","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD1","description":"ICD-OCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38500","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC1","description":"ICD-KIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4B","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC0","description":"ICD-DIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67101","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID1","description":"ICD-IBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE1","description":"ICD-JEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC1","description":"ICD-KCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA0","description":"ICD-CEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2629","description":"Intro/sheath_ laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA43","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF0","description":"ICD-JAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD0","description":"ICD-KCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX17","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC46","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Odontics endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6010","description":"Odontics endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE0","description":"ICD-FCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54015","description":"Drain penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB0","description":"ICD-BALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2199","description":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28234","description":"Incision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB0","description":"ICD-GAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD1","description":"ICD-LFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML40","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28600","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC1","description":"ICD-OLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0950T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","description":"CPT-0950T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescent antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86255","description":"Fluorescent antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD0","description":"ICD-OLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","description":"HCPCS-G0553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce radius and ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25492","description":"Reinforce radius and ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydration status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2018F","description":"Hydration status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA0","description":"ICD-BEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB0","description":"ICD-BGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98980","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC1","description":"ICD-JAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA0","description":"ICD-ABIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90627","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB0","description":"ICD-MIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF0","description":"ICD-NAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1001","description":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB1","description":"ICD-PGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1341","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cvr knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5706","description":"Custom shape cvr knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pentastarch 10% solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2513","description":"Pentastarch 10% solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7900","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD1","description":"ICD-OGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF1","description":"ICD-KEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy hamstring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27325","description":"Neurectomy hamstring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95147","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guide nerv destr elec stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95873","description":"Guide nerv destr elec stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC34","description":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF1","description":"ICD-FDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb bone add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11047","description":"Deb bone add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF0","description":"ICD-KEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF0","description":"ICD-LHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB0","description":"ICD-NGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add horseshoe toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3560","description":"O shoe add horseshoe toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo prox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4080","description":"Repl met band kafo-afo prox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC0","description":"ICD-GAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA1","description":"ICD-OLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB1","description":"ICD-NKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF0","description":"ICD-DBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9598","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30468","description":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med nutrition indiv subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97803","description":"Med nutrition indiv subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64495","description":"Inj paravert f jnt l/s 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB52","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB0","description":"ICD-CHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE1","description":"ICD-GCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB0","description":"ICD-MEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC0","description":"ICD-NAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB0","description":"ICD-KASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59425","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL01","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36556","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC230","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0515T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF0","description":"ICD-MDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF0","description":"ICD-BHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed hvy dty xtra wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0303","description":"Hosp bed hvy dty xtra wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had history of immunocompromising conditions prior to or during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1158","description":"Patient had history of immunocompromising conditions prior to or during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB0","description":"ICD-BIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB0","description":"ICD-FIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0605U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","description":"CPT-0605U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF0","description":"ICD-NCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC0","description":"ICD-FBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA0","description":"ICD-JFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carry d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8986","description":"Carry d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF0","description":"ICD-FAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB1","description":"ICD-ACAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC0","description":"ICD-JGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD0","description":"ICD-GIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB1","description":"ICD-FAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE0","description":"ICD-JDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2B","description":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF1","description":"ICD-GHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv authrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86079","description":"Phys blood bank serv authrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX03","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27329","description":"Resect thigh/knee tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Department of Veterans Affairs Whole Health Partner Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9004","description":"Department of Veterans Affairs Whole Health Partner Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA1","description":"ICD-CANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc nhlstg 1-2 no relap no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9134","description":"Onc nhlstg 1-2 no relap no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF0","description":"ICD-BBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF1","description":"ICD-CDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB0","description":"ICD-NLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","description":"HCPCS-A9616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2136","description":"Kafo femoral fx cast rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46940","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD115","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA1","description":"ICD-GFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0646T","description":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xenograft implantation into the articular surface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0737T","description":"Xenograft implantation into the articular surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF0","description":"ICD-PARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB0","description":"ICD-GDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE0","description":"ICD-LCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD1","description":"ICD-OGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE0","description":"ICD-GANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA1","description":"ICD-BINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC1","description":"ICD-IBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell >=15% (hiv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3498F","description":"Cd4+ cell >=15% (hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB0","description":"ICD-PCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe caliper plate new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3610","description":"Trans shoe caliper plate new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flexible metal hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6610","description":"Flexible metal hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea not screened","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3452F","description":"Dyspnea not screened","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB0","description":"ICD-ACLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE0","description":"ICD-NAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8C","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA1","description":"ICD-GEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC0","description":"ICD-AIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD1","description":"ICD-OFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv vaccine 4-6 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90696","description":"Dtap-ipv vaccine 4-6 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monitoring feature/devicenoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9279","description":"Monitoring feature/devicenoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gerd symps assessed 12 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1118F","description":"Gerd symps assessed 12 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2129","description":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Daily cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0512","description":"Daily cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guided tiss regen resorble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4266","description":"Guided tiss regen resorble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB1","description":"ICD-LGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF0","description":"ICD-CBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC0","description":"ICD-NJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE1","description":"ICD-NBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FMRI brain by phys/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70555","description":"FMRI brain by phys/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8D","description":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME0","description":"ICD-EIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF1","description":"ICD-MFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1303","description":"Injection_ ravulizumab-cwvz_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF0","description":"ICD-CBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF0","description":"ICD-CEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD0","description":"ICD-OASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp prob 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87501","description":"Influenza dna amp prob 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","description":"HCPCS-J3391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01200","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","description":"CPT-01200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43252","description":"Egd optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow up care plan mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545F","description":"Follow up care plan mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND0","description":"ICD-BEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63011","description":"Remove spine lamina 1/2 scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0868T","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD0","description":"ICD-OKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082U","description":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF1","description":"ICD-OIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA0","description":"ICD-CDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA0","description":"ICD-CGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9656","description":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD0","description":"ICD-GHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complex body section x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76101","description":"Complex body section x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy live donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44133","description":"Enterectomy live donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01931","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","description":"CPT-01931","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA1","description":"ICD-KGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low pecarn ped head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9593","description":"Low pecarn ped head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC1","description":"ICD-NFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE214","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC11","description":"ICD-1HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF0","description":"ICD-FFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert emergency airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31500","description":"Insert emergency airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD1","description":"ICD-IIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC1","description":"ICD-PCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE0","description":"ICD-NIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB1","description":"ICD-BCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC1","description":"ICD-FDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of aide_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0156","description":"Hhcp-svs of aide_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC1","description":"ICD-OFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF0","description":"ICD-AFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89353","description":"Thawing cryopresrved sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6540","description":"Gc stocking waistlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF1","description":"ICD-OKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA0","description":"ICD-OJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8A","description":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post op service lvrs min 6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0305","description":"Post op service lvrs min 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pinworm exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87172","description":"Pinworm exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB0","description":"ICD-GBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF0","description":"ICD-OBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC214","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Natalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2323","description":"Natalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess cyst contrast inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49424","description":"Assess cyst contrast inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB0","description":"ICD-CFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF0","description":"ICD-KDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE0","description":"ICD-CIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA1","description":"ICD-OFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF1","description":"ICD-AFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"H2o stat docd dehydrated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2031F","description":"H2o stat docd dehydrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0852","description":"Pwc gp 3 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42310","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Positioning cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0190","description":"Positioning cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj meniscectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7850","description":"Tmj meniscectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA1","description":"ICD-PCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn incomp inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9302","description":"Norsn incomp inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE0","description":"ICD-FCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80334","description":"Antidepressants class 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF0","description":"ICD-EEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF1","description":"ICD-ADMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiographic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76499","description":"Radiographic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0105","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0105","description":"CDT-D0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of phrenic nerve stimulator transvenous lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33281","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paclitaxel protein bound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9264","description":"Paclitaxel protein bound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs scalp vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36405","description":"Bl draw <3 yrs scalp vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50953","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc dr wh motor/gear comb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2370","description":"Pwr wc dr wh motor/gear comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC1","description":"ICD-PJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin reuse pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5560","description":"Insulin reuse pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD0","description":"ICD-FHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27202","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC0","description":"ICD-PEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE1","description":"ICD-CECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD0","description":"ICD-GEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0579U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","description":"CPT-0579U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric partial denture fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6985","description":"Pediatric partial denture fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD1","description":"ICD-FHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal trnspl endothelial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65756","description":"Corneal trnspl endothelial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJB0","description":"ICD-BEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilat macular exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2021F","description":"Dilat macular exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54304","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA1","description":"ICD-OKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA1","description":"ICD-AGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC1","description":"ICD-KHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF1","description":"ICD-NFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA1","description":"ICD-NITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","description":"HCPCS-J0615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport case worker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0160","description":"Noner transport case worker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD1","description":"ICD-GDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE1","description":"ICD-JDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD0","description":"ICD-JAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB204","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9365","description":"Hit tpn 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41006","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aminophyllin 250 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0280","description":"Aminophyllin 250 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA1","description":"ICD-OLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91318","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE0","description":"ICD-FGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43334","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5A","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group mnt 2 or more 30 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0271","description":"Group mnt 2 or more 30 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC0","description":"ICD-NDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom fab w/c back cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2617","description":"Custom fab w/c back cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA21","description":"ICD-1FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA1","description":"ICD-OIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE1","description":"ICD-BECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD0","description":"ICD-BCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ire abltj 1+tumors open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0601T","description":"Ire abltj 1+tumors open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB0","description":"ICD-AIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD0","description":"ICD-OISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL35","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE1","description":"ICD-GEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC0","description":"ICD-CEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF1","description":"ICD-IECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-62331","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","description":"CPT-62331","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove colloid cyst w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62162","description":"Remove colloid cyst w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB0","description":"ICD-JGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0807T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0070U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD1","description":"ICD-ABAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB13","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC0","description":"ICD-OFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB0","description":"ICD-GDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1498","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","description":"HCPCS-M1498","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6193","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6193","description":"CDT-D6193","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release forearm/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26449","description":"Release forearm/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB0","description":"ICD-DEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE0","description":"ICD-NGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9601","description":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay dipstick","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83518","description":"Immunoassay dipstick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ epirubicin hcl_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9178","description":"Inj_ epirubicin hcl_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA1","description":"ICD-BHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1002","description":"HCPCS-A1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c quant rna tstng docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3220F","description":"Hep c quant rna tstng docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3D","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrnd unhlthy oh use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3016F","description":"Pt scrnd unhlthy oh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denervation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27035","description":"Denervation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Val rsn hd ct ord reg indic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9595","description":"Val rsn hd ct ord reg indic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB0","description":"ICD-OLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF0","description":"ICD-BADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE1","description":"ICD-FBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sulfamethoxazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0039","description":"Injection_ sulfamethoxazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24360","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD0","description":"ICD-FFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81347","description":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC0","description":"ICD-NHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC1","description":"ICD-JHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31365","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD1","description":"ICD-CBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE0","description":"ICD-OHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF0","description":"ICD-LGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD0","description":"ICD-AFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA1","description":"ICD-DDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE1","description":"ICD-CIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF1","description":"ICD-EETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD1","description":"ICD-PIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery for hearing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5266","description":"Battery for hearing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD0","description":"ICD-EAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99402","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB0","description":"ICD-NIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cataract measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8906","description":"Cataract measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA11","description":"ICD-1BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PAS (Consumer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1792","description":"PAS (Consumer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA55","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61480","description":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6600","description":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC1","description":"ICD-BBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE0","description":"ICD-DGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE1","description":"ICD-DAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","description":"HCPCS-M1422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD1","description":"ICD-OKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC0","description":"ICD-JFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75946","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC0","description":"ICD-BCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF1","description":"ICD-CFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA0","description":"ICD-JBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/transplant tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23440","description":"Remove/transplant tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE0","description":"ICD-KCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB1","description":"ICD-CBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD1","description":"ICD-NEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA1","description":"ICD-GGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1503","description":"HCPCS-B1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","description":"CPT-01220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61535","description":"Remove brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ra measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8490","description":"Ra measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF0","description":"ICD-KDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC0","description":"ICD-OCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE0","description":"ICD-GINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA0","description":"ICD-OAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD1","description":"ICD-KDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE0","description":"ICD-JENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE0","description":"ICD-JDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF0","description":"ICD-KHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA0","description":"ICD-PDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8655","description":"Fun stat score le >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB1","description":"ICD-GHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","description":"CPT-00214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA1","description":"ICD-GIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB0","description":"ICD-JGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70488","description":"Ct maxillofacial w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB1","description":"ICD-KEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD0","description":"ICD-NLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16077","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA1","description":"ICD-CDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF0","description":"ICD-BDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA1","description":"ICD-NLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD1","description":"ICD-NKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect recur gyn mal w/lym","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58958","description":"Resect recur gyn mal w/lym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21461","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE1","description":"ICD-EEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Housing & integrated adhesiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7508","description":"Housing & integrated adhesiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC1","description":"ICD-JCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB1","description":"ICD-FIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"KLF1 TARGETED SEQUENCING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195U","description":"KLF1 TARGETED SEQUENCING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD0","description":"ICD-IIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC0","description":"ICD-CIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE1","description":"ICD-NJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA1","description":"ICD-FHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF0","description":"ICD-ABTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA1","description":"ICD-AAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE0","description":"ICD-ECTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sirolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80195","description":"Assay of sirolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB0","description":"ICD-MEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI fetal sngl/1st gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74712","description":"MRI fetal sngl/1st gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC0","description":"ICD-JFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE0","description":"ICD-BCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE0","description":"ICD-BDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67005","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA0","description":"ICD-GBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC0","description":"ICD-JHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99238","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD1","description":"ICD-GIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAB0","description":"ICD-NFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD1","description":"ICD-KISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD1","description":"ICD-OCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB211","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA151","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB25","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD1","description":"ICD-KIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27448","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy snare les remv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43217","description":"Esophagoscopy snare les remv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF1","description":"ICD-KGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esano aaa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4273","description":"Esano aaa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35371","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1300","description":"Whirlpool portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB1","description":"ICD-AHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC31","description":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA11","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX36","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA0","description":"ICD-NCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD1","description":"ICD-AIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD0","description":"ICD-OFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB1","description":"ICD-CHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25119","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE1","description":"ICD-FIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0366","description":"Cone beam ct interprete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc mi 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92941","description":"Prq card revasc mi 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft contral carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35509","description":"Art byp grft contral carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF0","description":"ICD-FCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB1","description":"ICD-MAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8911","description":"Pt doc no fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD1","description":"ICD-ACMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of endocrine hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84235","description":"Assay of endocrine hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 12-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87507","description":"Iadna-dna/rna probe tq 12-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59350","description":"Repair of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE1","description":"ICD-IAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2c19 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81225","description":"Cyp2c19 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75885","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA1","description":"ICD-IAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behav hlth day treat_ per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2012","description":"Behav hlth day treat_ per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA1","description":"ICD-NAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of pubic bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27282","description":"Fusion of pubic bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67400","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB1","description":"ICD-JFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA42","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB1","description":"ICD-GDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF0","description":"ICD-CFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","description":"HCPCS-Q4402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reposition vad diff session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33993","description":"Reposition vad diff session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF0","description":"ICD-CEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE0","description":"ICD-MIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD0","description":"ICD-MEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE1","description":"ICD-CCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB1","description":"ICD-CDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD0","description":"ICD-HEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90650","description":"2vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA0","description":"ICD-OCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ercp w/specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43260","description":"Ercp w/specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9049","description":"Injection_ tagraxofusp-erzs_ 10mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95251","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0641U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0641U","description":"CPT-0641U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD110","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC0","description":"ICD-BDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD0","description":"ICD-CFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2267","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA56","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE0","description":"ICD-BADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin reuse pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5561","description":"Insulin reuse pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA0","description":"ICD-HBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9051","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE0","description":"ICD-KELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8420","description":"Custom gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27827","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8576","description":"No postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC1","description":"ICD-CFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0873T","description":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smear special stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87207","description":"Smear special stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valvotomy pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33471","description":"Valvotomy pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0088","description":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF0","description":"ICD-GBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clean rem part denture mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9935","description":"Clean rem part denture mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD0","description":"ICD-PDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND0","description":"ICD-OBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25445","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA0","description":"ICD-KHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA1","description":"ICD-MIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palate/uvula surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42299","description":"Palate/uvula surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0541T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF0","description":"ICD-OKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD0","description":"ICD-FDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD0","description":"ICD-DFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD1","description":"ICD-FHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63707","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duodenal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91022","description":"Duodenal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23420","description":"Repair of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA0","description":"ICD-FGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD0","description":"ICD-KDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB1","description":"ICD-NFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43757","description":"Dx duod intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36860","description":"External cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal extent unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9095","description":"Onc dx rectal extent unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB1","description":"ICD-KCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE0","description":"ICD-NLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA0","description":"ICD-GITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lodging per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9976","description":"Lodging per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo cap design w/o jnt cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3975","description":"Sewhfo cap design w/o jnt cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc occup therapy ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0160","description":"Hhc occup therapy ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC0","description":"ICD-HCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/fast/dir lab ldl-c >190","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9675","description":"Pt w/fast/dir lab ldl-c >190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC1","description":"ICD-MALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE1","description":"ICD-MHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE0","description":"ICD-FGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/clin ascvd dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9674","description":"Pt w/clin ascvd dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB1","description":"ICD-JIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE134","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9926","description":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crisis intervention mental h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9485","description":"Crisis intervention mental h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB0","description":"ICD-JHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF1","description":"ICD-HHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroguide for spine inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77003","description":"Fluoroguide for spine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE0","description":"ICD-KDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551T","description":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0675T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9885","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2060","description":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12001","description":"Rpr s/n/ax/gen/trnk 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB0","description":"ICD-NCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB0","description":"ICD-CFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC0","description":"ICD-KEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33778","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC1","description":"ICD-GGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF0","description":"ICD-JBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC113","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8711","description":"Pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF1","description":"ICD-OLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Private duty/independent nsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1000","description":"Private duty/independent nsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8F","description":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF1","description":"ICD-KBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE0","description":"ICD-KHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC0","description":"ICD-JCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC0","description":"ICD-BFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC1","description":"ICD-BAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC1","description":"ICD-FHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC1","description":"ICD-EDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD0","description":"ICD-LAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC1","description":"ICD-NKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88249","description":"Chromosome analysis 100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA1","description":"ICD-BBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27566","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD1","description":"ICD-OHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB50","description":"High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE1","description":"ICD-OHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87492","description":"Chylmd trach dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power wheelchair noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0898","description":"Power wheelchair noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aneurysm press sensor add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34806","description":"Aneurysm press sensor add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70332","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain canal shunt procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61070","description":"Brain canal shunt procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of midfoot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28800","description":"Amputation of midfoot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9351","description":"Hit cont antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21143","description":"Lefort i-3/> piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7201","description":"Factor ix fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD1","description":"ICD-OEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE1","description":"ICD-FGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME0","description":"ICD-FCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC0","description":"ICD-MGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE0","description":"ICD-IHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB0","description":"ICD-CEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1308","description":"Influenza immunization was not administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB0","description":"ICD-CDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB0","description":"ICD-CIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE1","description":"ICD-NKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1073","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","description":"HCPCS-J1073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57220","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB213","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 75 or older on their initiation of dialysis date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1264","description":"Patients age 75 or older on their initiation of dialysis date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME1","description":"ICD-GIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"remove broken implant retaining screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6096","description":"remove broken implant retaining screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5170","description":"Hearing aid_ CROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC1","description":"ICD-BEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wnd tx 249cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4720","description":"Dialysat sol fld vol > 249cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA0","description":"ICD-PLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69910","description":"Remove inner ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Six volt bat otto bock/eq ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7360","description":"Six volt bat otto bock/eq ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC240","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28055","description":"Neurectomy foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB0","description":"ICD-ABAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC0","description":"ICD-JHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB0","description":"ICD-BFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95720","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92201","description":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB0","description":"ICD-MIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB0","description":"ICD-MCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c wdth 20-23 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2340","description":"W/c wdth 20-23 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96130","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8H","description":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anal pressure record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91122","description":"Anal pressure record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB0","description":"ICD-BDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB1","description":"ICD-ODQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA0","description":"ICD-AGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26742","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx compl front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21344","description":"Open tx compl front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace afo soft interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4392","description":"Replace afo soft interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert heart pm ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33207","description":"Insert heart pm ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Renal function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80069","description":"Renal function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA0","description":"ICD-BFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE220","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn for gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9230","description":"Norsn for gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6606","description":"Gradient compression bandaging supply_ padded textile_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart symp image plnr spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332T","description":"Heart symp image plnr spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetoscop laser ther ttts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2411","description":"Fetoscop laser ther ttts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF1","description":"ICD-JEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9168","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33771","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift mechanism toilet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0172","description":"Seat lift mechanism toilet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus endoscopy/ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43205","description":"Esophagus endoscopy/ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC11","description":"ICD-2DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC0","description":"ICD-FGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj metaraminol bitartrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0380","description":"Inj metaraminol bitartrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388T","description":"Transcatheter removal of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE0","description":"ICD-KGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA1","description":"ICD-MEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD0","description":"ICD-GHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","description":"HCPCS-Q4431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD0","description":"ICD-JEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND0","description":"ICD-BFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block stellate ganglion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64510","description":"N block stellate ganglion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15769","description":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ neurostimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1778","description":"Lead_ neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA0","description":"ICD-PCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD0","description":"ICD-EICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure dev_ vasc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1760","description":"Closure dev_ vasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC1","description":"ICD-HGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE1","description":"ICD-FHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB1","description":"ICD-CAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE1","description":"ICD-JEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61868","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF0","description":"ICD-FFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA0","description":"ICD-GANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB1","description":"ICD-JCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF1","description":"ICD-NKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE1","description":"ICD-JIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND1","description":"ICD-CHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD1","description":"ICD-BBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vena cava filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1880","description":"Vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE111","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF1","description":"ICD-CGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC1","description":"ICD-GAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF0","description":"ICD-JELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE0","description":"ICD-KEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE1","description":"ICD-ADEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD0","description":"ICD-LFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333U","description":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"A finding of an incidental pulmonary nodule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9754","description":"A finding of an incidental pulmonary nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46221","description":"Ligation of hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33935","description":"Transplantation heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aortic anrysm 6/> cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9004F","description":"Aortic anrysm 6/> cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA0","description":"ICD-KCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD1","description":"ICD-CASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1B","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt has no resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1505F","description":"Pt has no resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208T","description":"Audiometry air only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad intra w/o bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33982","description":"Replace vad intra w/o bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF1","description":"ICD-GBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE0","description":"ICD-EFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB0","description":"ICD-MACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vag lesions simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57061","description":"Destroy vag lesions simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3372F","description":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA1","description":"ICD-CIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1198","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC11","description":"ICD-4IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD1","description":"ICD-KGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0618","description":"Audiometry for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB0","description":"ICD-BAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9708","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB1","description":"ICD-GHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","description":"CPT-87812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF1","description":"ICD-CEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA0","description":"ICD-GCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD1","description":"ICD-NFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC1","description":"ICD-CIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genitourinary nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78799","description":"Genitourinary nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE1","description":"ICD-NKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD125","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35051","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head/neck/ptrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30051","description":"Anesth head/neck/ptrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release palm/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26440","description":"Release palm/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA0","description":"ICD-EELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero & or pyeloscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52351","description":"Cystouretero & or pyeloscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD0","description":"ICD-CFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65760","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC10","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52265","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4003","description":"Emergency Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metered dose inhaler drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3535","description":"Metered dose inhaler drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt couns 4 txmnt opt prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4163F","description":"Pt couns 4 txmnt opt prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD1","description":"ICD-PHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA21","description":"ICD-2GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA0","description":"ICD-HAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE1","description":"ICD-CFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD1","description":"ICD-KDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD0","description":"ICD-GGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD230","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE1","description":"ICD-ODAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50947","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meals for clinical trial par","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9996","description":"Meals for clinical trial par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF1","description":"ICD-IHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF0","description":"ICD-MCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA0","description":"ICD-FHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6205","description":"Composite drsg > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF1","description":"ICD-EEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy cleaning brush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4626","description":"Tracheostomy cleaning brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB0","description":"ICD-JENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB106","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC0","description":"ICD-IAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2312","description":"Lens sphc trifo 7.25-12/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA0","description":"ICD-GICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE0","description":"ICD-IGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder/vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51900","description":"Repair bladder/vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB0","description":"ICD-OKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22514","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF0","description":"ICD-IDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC0","description":"ICD-NFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0717T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE0","description":"ICD-EAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable endoscope sheath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4270","description":"Disposable endoscope sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF1","description":"ICD-JHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7205","description":"Factor viii fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB0","description":"ICD-IBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC1","description":"ICD-NKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31050","description":"Exploration sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64645","description":"Chemodenerv 1 extrem 5/> ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF1","description":"ICD-AFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2B","description":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9713","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB0","description":"ICD-NFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB0","description":"ICD-KIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA1","description":"ICD-LHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA1","description":"ICD-JHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC1","description":"ICD-GHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF0","description":"ICD-KFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA1","description":"ICD-KEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA0","description":"ICD-AIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF1","description":"ICD-CBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB1","description":"ICD-NEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE0","description":"ICD-BBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF0","description":"ICD-OIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54700","description":"Drainage of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icm device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93297","description":"Icm device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA0","description":"ICD-MAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fancc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81242","description":"Fancc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED1","description":"ICD-JGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB0","description":"ICD-LEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC1","description":"ICD-IBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA1","description":"ICD-LIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD1","description":"ICD-NDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25071","description":"Exc forearm les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21465","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35189","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF1","description":"ICD-GHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA0","description":"ICD-FAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj magnesium sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3475","description":"Inj magnesium sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9306","description":"Injection_ pertuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-durometer symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5661","description":"Multi-durometer symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9782","description":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0699","description":"Injection_ cefiderocol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB1","description":"ICD-AICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD1","description":"ICD-OIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4269","description":"Surgraft xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Varus/valgus strap padded/li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2270","description":"Varus/valgus strap padded/li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB1","description":"ICD-KIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Congenital Neutropenia Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271U","description":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Congenital Neutropenia Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD0","description":"ICD-FFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5411","description":"Dentures adjust cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC241","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB1","description":"ICD-CCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE0","description":"ICD-IFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF1","description":"ICD-PAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC0","description":"ICD-OASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump portab hom modl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0600","description":"Suction pump portab hom modl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0527","description":"Management of established patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC1","description":"ICD-KGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC1","description":"ICD-IIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6712","description":"Ped term dev_ hook_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77768","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC1","description":"ICD-AEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA24","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnio quad-core_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4294","description":"Amnio quad-core_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE1","description":"ICD-GEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF1","description":"ICD-PFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urea nitrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84520","description":"Assay of urea nitrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27685","description":"Revision of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph imped funct test > 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91038","description":"Esoph imped funct test > 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93279","description":"Pm device progr eval sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC0","description":"ICD-NIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6082","description":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB0","description":"ICD-NJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB0","description":"ICD-GBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 1.1-5.0cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11951","description":"Tx contour defects 1.1-5.0cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE160","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD1","description":"ICD-GALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epi etiol synd rvwd and docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1205F","description":"Epi etiol synd rvwd and docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA1","description":"ICD-KBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA0","description":"ICD-MJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE0","description":"ICD-FBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69604","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cros hearing aid dispens fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5200","description":"Cros hearing aid dispens fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA0","description":"ICD-AFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74283","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0467","description":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA1","description":"ICD-OFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93574","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB1","description":"ICD-CEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation without programming of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93153","description":"Interrogation without programming of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","description":"HCPCS-J0458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB1","description":"ICD-GDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27181","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99283","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA1","description":"ICD-CGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9153","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB1","description":"ICD-JFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB111","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0659","description":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB0","description":"ICD-KBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA0","description":"ICD-CHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0231","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0231","description":"HCPCS-M0231","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB0","description":"ICD-GDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB1","description":"ICD-GHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous rf vein add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36476","description":"Endovenous rf vein add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2142","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF0","description":"ICD-JFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29847","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad w backup invasive intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0472","description":"Rad w backup invasive intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC0","description":"ICD-MDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70460","description":"Ct head/brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oasis wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4102","description":"Oasis wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC45","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD0","description":"ICD-NCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82435","description":"Assay of blood chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE1","description":"ICD-BGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC1","description":"ICD-JBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA1","description":"ICD-OCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6538","description":"Gc stocking full lngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE0","description":"ICD-KCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy ring each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4404","description":"Ostomy ring each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap remove rectum w/pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45397","description":"Lap remove rectum w/pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB1","description":"ICD-OIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo spiral molded to pt plas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1950","description":"Afo spiral molded to pt plas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no sleep apnea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8840","description":"Doc reas no sleep apnea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE0","description":"ICD-KDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF1","description":"ICD-CBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD0","description":"ICD-BIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","description":"HCPCS-Q4424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF1","description":"ICD-BEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6573","description":"Gradient compression garment_ toe caps_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE1","description":"ICD-HBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA0","description":"ICD-GAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sildenafil citrate_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0090","description":"Sildenafil citrate_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA0","description":"ICD-KBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA1","description":"ICD-AFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC1","description":"ICD-NFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee disarticulat leather so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5640","description":"Knee disarticulat leather so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA1","description":"ICD-OBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carbamazepine; -10_11-Epoxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80161","description":"Carbamazepine; -10_11-Epoxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01682","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","description":"CPT-01682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w iv ab given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8916","description":"Pt w iv ab given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65130","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1002","description":"HCPCS-C1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62350","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE0","description":"ICD-OBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB21","description":"ICD-1GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC0","description":"ICD-KHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF0","description":"ICD-BATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32905","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pentobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2515","description":"Pentobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD1","description":"ICD-DHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92235","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD1","description":"ICD-NJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cataract mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8765","description":"Cataract mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn scope pt >85y","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9660","description":"Doc med rsn scope pt >85y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0499T","description":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE0","description":"ICD-NDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL33","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE0","description":"ICD-KHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sleep study unatt&resp efft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95806","description":"Sleep study unatt&resp efft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE1","description":"ICD-GCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF1","description":"ICD-CGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","description":"HCPCS-Q4397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gr24 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2362","description":"Gr24 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abobotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0586","description":"Abobotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB0","description":"ICD-KFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3D","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD1","description":"ICD-BBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580T","description":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA0","description":"ICD-OKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE1","description":"ICD-HFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iris support intraoclr lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2631","description":"Iris support intraoclr lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA1","description":"ICD-EACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA0","description":"ICD-JBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2049","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2049","description":"HCPCS-A2049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE0","description":"ICD-OFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1459","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","description":"HCPCS-M1459","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD1","description":"ICD-JFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF1","description":"ICD-NFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow stump activated lock h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6130","description":"Elbow stump activated lock h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide gu dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74485","description":"X-ray guide gu dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC0","description":"ICD-BGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diab shoe w/metatarsal bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5505","description":"Diab shoe w/metatarsal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24126","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow w/deb open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24358","description":"Repair elbow w/deb open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23105","description":"Remove shoulder joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76529","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51520","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0030U","description":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE1","description":"ICD-JICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE1","description":"ICD-GDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF1","description":"ICD-OAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD0","description":"ICD-OGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84105","description":"Assay of urine phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC1","description":"ICD-GGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC1","description":"ICD-FBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7682","description":"Tobramycin non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB1","description":"ICD-EBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB1","description":"ICD-BFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26497","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE1","description":"ICD-OLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF1","description":"ICD-PHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB0","description":"ICD-IGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj potassium chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3480","description":"Inj potassium chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC1","description":"ICD-BEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF1","description":"ICD-FHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC1","description":"ICD-DDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC1","description":"ICD-FBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA0","description":"ICD-FFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD226","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68841","description":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB234","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC1","description":"ICD-GFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA0","description":"ICD-KGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC14","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA0","description":"ICD-NBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Per pm reeval est pat 65+ yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99397","description":"Per pm reeval est pat 65+ yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD0","description":"ICD-KAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB1","description":"ICD-FECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t1no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9077","description":"Onc dx prostate t1no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect tarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28171","description":"Resect tarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31299","description":"Sinus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC0","description":"ICD-GGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB0","description":"ICD-NGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1833","description":"Ko adj jnt pos r sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD1","description":"ICD-OCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE1","description":"ICD-LAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28450","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF1","description":"ICD-CAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74775","description":"X-ray exam of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE1","description":"ICD-KCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB0","description":"ICD-CEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-47384","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","description":"CPT-47384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC226","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD1","description":"ICD-KHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive management and care coordination for advanced illness_ per calendar month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0311","description":"Comprehensive management and care coordination for advanced illness_ per calendar month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC0","description":"ICD-NFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99356","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received active chemotherapy any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1156","description":"Patient received active chemotherapy any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB0","description":"ICD-CHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA0","description":"ICD-KELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"D/c hemo or perit dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9523","description":"D/c hemo or perit dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No hist cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3493F","description":"No hist cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt simple w/o comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77520","description":"Proton trmt simple w/o comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis access system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1881","description":"Dialysis access system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA0","description":"ICD-AFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD1","description":"ICD-AEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ neurostim test kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1897","description":"Lead_ neurostim test kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB0","description":"ICD-OKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB0","description":"ICD-KBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE1","description":"ICD-AHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/exc of tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31540","description":"Laryngoscopy w/exc of tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA1","description":"ICD-BHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF0","description":"ICD-DBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE0","description":"ICD-KDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection pantroprazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0164","description":"Injection pantroprazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2388","description":"Foam drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","description":"HCPCS-J2516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nsg aide service up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1004","description":"Nsg aide service up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE1","description":"ICD-BAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urea injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3350","description":"Urea injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"WoundEx_ BioSkin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4163","description":"WoundEx_ BioSkin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB0","description":"ICD-BCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME0","description":"ICD-GBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC1","description":"ICD-HGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD112","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA0","description":"ICD-BHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"V-band gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43842","description":"V-band gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD1","description":"ICD-JBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC0","description":"ICD-JCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatases","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84080","description":"Assay alkaline phosphatases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC1","description":"ICD-FAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alkaloids nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80323","description":"Alkaloids nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 12 COM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216U","description":"NEURO INH ATAXIA DNA 12 COM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC1","description":"ICD-MJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6890","description":"Prefab glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF1","description":"ICD-CHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC0","description":"ICD-KCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63077","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID1","description":"ICD-KDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43242","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE0","description":"ICD-KCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE156","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-ray each vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75774","description":"Artery x-ray each vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99244","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD0","description":"ICD-AHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair retinal detach cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67113","description":"Repair retinal detach cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penile contracture device_ manual_ greater than 3 lbs traction force","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4988","description":"Penile contracture device_ manual_ greater than 3 lbs traction force","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF0","description":"ICD-OFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC0","description":"ICD-MFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MLG-Complete_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4256","description":"MLG-Complete_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA0","description":"ICD-JGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD0","description":"ICD-OEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC1","description":"ICD-PEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE1","description":"ICD-CGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen metacarpal/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26568","description":"Lengthen metacarpal/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42410","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92650","description":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22310","description":"Closed tx vert fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens variable asphericity bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2430","description":"Lens variable asphericity bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8X","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abscess imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78806","description":"Abscess imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA1","description":"ICD-OBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt or manip for maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8990","description":"Pt or manip for maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB0","description":"ICD-KBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60505","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA0","description":"ICD-ODFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD0","description":"ICD-MITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC0","description":"ICD-GDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD0","description":"ICD-IBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nb resuscitation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99465","description":"Nb resuscitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD1","description":"ICD-KACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA03","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC1","description":"ICD-OAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC0","description":"ICD-MCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38300","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD1","description":"ICD-OIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fracture assessment via dxa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77086","description":"Fracture assessment via dxa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67825","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Escharotomy addl incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16036","description":"Escharotomy addl incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-43889","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","description":"CPT-43889","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42835","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reagent strip/blood glucose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82948","description":"Reagent strip/blood glucose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us nuchal meas add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76814","description":"Ob us nuchal meas add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD1","description":"ICD-OIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove & treat brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61544","description":"Remove & treat brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-rays at surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74301","description":"X-rays at surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB1","description":"ICD-NGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8C","description":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calcitrol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0169","description":"Calcitrol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB0","description":"ICD-FCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cervical collar molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0170","description":"Cervical collar molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF0","description":"ICD-CGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD0","description":"ICD-OJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Novafix dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4254","description":"Novafix dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD1","description":"ICD-BFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD0","description":"ICD-MGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC0","description":"ICD-KITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC0","description":"ICD-JAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF0","description":"ICD-CHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE0","description":"ICD-OECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC0","description":"ICD-OHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE1","description":"ICD-JECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA30","description":"Low Rehab_ ADL Index 0-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9316","description":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD0","description":"ICD-OCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hook to hand cable adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6670","description":"Hook to hand cable adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12002","description":"Rpr s/n/ax/gen/trnk2.6-7.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD101","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC1","description":"ICD-PHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50782","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF0","description":"ICD-ICHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair communication device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5336","description":"Repair communication device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","description":"HCPCS-J3403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA54","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55880","description":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF0","description":"ICD-MIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21085","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB1","description":"ICD-MCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431T","description":"Rmvl/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD0","description":"ICD-GAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA1","description":"ICD-KFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm autogrft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15111","description":"Epidrm autogrft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA0","description":"ICD-IGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gadofosveset trisodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9583","description":"Gadofosveset trisodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC214","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00222","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","description":"CPT-00222","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6069","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA1","description":"ICD-NACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA0","description":"ICD-IFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27232","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rxt breast appl place/remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9726","description":"Rxt breast appl place/remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet imaging initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0252","description":"Pet imaging initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA1","description":"ICD-OBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE0","description":"ICD-KHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC0","description":"ICD-DGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC0","description":"ICD-JEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nitrogen n-13 ammonia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9526","description":"Nitrogen n-13 ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12036","description":"Intmd rpr s/a/t/ext 20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB0","description":"ICD-NHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD1","description":"ICD-EFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC1","description":"ICD-BDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nose to lip fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42260","description":"Repair nose to lip fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC1","description":"ICD-DIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA1","description":"ICD-AGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA1","description":"ICD-NAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96381","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA0","description":"ICD-FABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27324","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4125","description":"Arthroflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD231","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC156","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF0","description":"ICD-KGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vantas implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9225","description":"Vantas implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15837","description":"Excise excess skin arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB1","description":"ICD-MGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9077","description":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC0","description":"ICD-MITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-appro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2001","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-appro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF0","description":"ICD-AFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove aortic assist device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33968","description":"Remove aortic assist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1802","description":"CDT-D1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB0","description":"ICD-OEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB0","description":"ICD-OGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA01","description":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA0","description":"ICD-EEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Op rad mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9238","description":"Op rad mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC1","description":"ICD-CFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB31","description":"ICD-2EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL32","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevat legrst up hangr brack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0047","description":"Elevat legrst up hangr brack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impl/redo electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43881","description":"Impl/redo electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME1","description":"ICD-ECME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftrst lower extension tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0043","description":"Ftrst lower extension tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96146","description":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ high noble me","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2720","description":"Crown resin w/ high noble me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF1","description":"ICD-LAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qty act card prev mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9677","description":"Qty act card prev mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE0","description":"ICD-FDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral knee allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27415","description":"Osteochondral knee allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35875","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exercise class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9451","description":"Exercise class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC1","description":"ICD-KBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB1","description":"ICD-EFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE1","description":"ICD-FDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy excl nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31525","description":"Dx laryngoscopy excl nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA1","description":"ICD-FCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC1","description":"ICD-JEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE1","description":"ICD-CCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA0","description":"ICD-KADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF1","description":"ICD-JGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Centruroides immune f(ab)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0716","description":"Centruroides immune f(ab)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA0","description":"ICD-NDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED1","description":"ICD-BFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9312","description":"HCPCS-C9312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing complete lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81372","description":"Hla i typing complete lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF0","description":"ICD-AHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0461","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0461","description":"CDT-D0461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pho doc >1 cecal ldmk com ex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9612","description":"Pho doc >1 cecal ldmk com ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB1","description":"ICD-MFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0996T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","description":"CPT-0996T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD1","description":"ICD-NGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID0","description":"ICD-AHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severity angina by actvty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1010F","description":"Severity angina by actvty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78499","description":"Cardiovascular nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna direct probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87149","description":"Dna/rna direct probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD0","description":"ICD-ODDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD1","description":"ICD-IHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc breast risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008M","description":"Onc breast risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA1","description":"ICD-HBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelet survival","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78191","description":"Platelet survival","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE0","description":"ICD-AHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD1","description":"ICD-MBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orth scottish r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1730","description":"Legg perthes orth scottish r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC0","description":"ICD-KBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24366","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE0","description":"ICD-NIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE1","description":"ICD-JFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA13","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93970","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF0","description":"ICD-FEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA104","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD1","description":"ICD-NDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45112","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77047","description":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC1","description":"ICD-MIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA0","description":"ICD-NADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB0","description":"ICD-CATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0256","description":"Hospital bed var ht w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB11","description":"ICD-4EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remv&replc pm gen dual lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33228","description":"Remv&replc pm gen dual lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML45","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42225","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA1","description":"ICD-FGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC0","description":"ICD-DBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost b/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7403","description":"Add ue prost b/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28140","description":"Removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures mandibl part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5214","description":"Dentures mandibl part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb subq tissue 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11042","description":"Deb subq tissue 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB1","description":"ICD-FGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE1","description":"ICD-GFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC1","description":"ICD-KHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA46","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit alpha-1-proteinas diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9346","description":"Hit alpha-1-proteinas diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC0","description":"ICD-ACTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC0","description":"ICD-JECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE0","description":"ICD-KFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA1","description":"ICD-PKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA0","description":"ICD-KCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE1","description":"ICD-ADTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF1","description":"ICD-OHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB0","description":"ICD-FGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped fbrglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4012","description":"Cast sup sht arm ped fbrglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA1","description":"ICD-CEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47146","description":"Prep donor liver/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB0","description":"ICD-MDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445U","description":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA245","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL60","description":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE0","description":"ICD-OEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF1","description":"ICD-IGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE1","description":"ICD-GBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF0","description":"ICD-GCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"corticotomy - one to three teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7296","description":"corticotomy - one to three teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB151","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE0","description":"ICD-JILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenytoin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1165","description":"Phenytoin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA0","description":"ICD-FBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF1","description":"ICD-JEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0647T","description":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF1","description":"ICD-OKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84110","description":"Assay of porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC1","description":"ICD-OANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF1","description":"ICD-JDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA0","description":"ICD-BBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin symp vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1004F","description":"Clin symp vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430U","description":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown-titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2794","description":"Crown-titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22836","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC1","description":"ICD-MHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD0","description":"ICD-ODQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61870","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD0","description":"ICD-GHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7669","description":"Metaproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22556","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clotting funct activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85397","description":"Clotting funct activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE0","description":"ICD-KCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE1","description":"ICD-NKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA1","description":"ICD-CEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspergillus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86606","description":"Aspergillus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE1","description":"ICD-GDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE0","description":"ICD-LFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aphakia prosth service temp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92358","description":"Aphakia prosth service temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE0","description":"ICD-IFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF0","description":"ICD-FGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunohistochemical stains","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0478","description":"Immunohistochemical stains","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1112","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA1","description":"ICD-FFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2300","description":"Arthroscopy_ shoulder_ surgi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE112","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0040U","description":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33269","description":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE1","description":"ICD-FIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51580","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0976","description":"Lso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sed rate nonautomated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85651","description":"Rbc sed rate nonautomated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE0","description":"ICD-KEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6070","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF0","description":"ICD-FDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF0","description":"ICD-CEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB0","description":"ICD-GCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxacillin sodium injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2700","description":"Oxacillin sodium injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toe joint transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26556","description":"Toe joint transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD1","description":"ICD-AGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC1","description":"ICD-GDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0203","description":"HCPCS-A0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap eye/nos/ear/lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15630","description":"Delay flap eye/nos/ear/lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fats/lipids feces quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82710","description":"Fats/lipids feces quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj fe-based mr contrast_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9953","description":"Inj fe-based mr contrast_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID0","description":"ICD-BDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF0","description":"ICD-AFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoabdominal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33877","description":"Thoracoabdominal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC1","description":"ICD-OIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE1","description":"ICD-MEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD1","description":"ICD-KHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB1","description":"ICD-LBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65772","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD1","description":"ICD-HEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67830","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj motion knee jnt lerman t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2186","description":"Adj motion knee jnt lerman t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF0","description":"ICD-BFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC1","description":"ICD-ODAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD1","description":"ICD-NICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA1","description":"ICD-CBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC1","description":"ICD-OGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC154","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA1","description":"ICD-JEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD1","description":"ICD-GHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB21","description":"ICD-1IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF0","description":"ICD-CGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Filtered speech hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92571","description":"Filtered speech hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch w bar/bltinconv/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4417","description":"Ost pch w bar/bltinconv/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233U","description":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16072","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16072","description":"CPT-16072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1077","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC0","description":"ICD-GGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53410","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test for acetone/ketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82009","description":"Test for acetone/ketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percut bx lung/mediastinum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32405","description":"Percut bx lung/mediastinum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF0","description":"ICD-OGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC1","description":"ICD-CHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of calf tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27687","description":"Revision of calf tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31382","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD0","description":"ICD-GGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67031","description":"Laser surgery eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brst prsth bra & bilat form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8002","description":"Brst prsth bra & bilat form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable gaseous 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0431","description":"Portable gaseous 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459U","description":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Micro w exam of surg margins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0474","description":"Micro w exam of surg margins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0876T","description":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC1","description":"ICD-GCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB31","description":"ICD-1FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF0","description":"ICD-OJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","description":"HCPCS-E1827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise lesion testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54512","description":"Excise lesion testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD1","description":"ICD-BBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD0","description":"ICD-JDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27222","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC0","description":"ICD-HEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measles and rubella virus vaccine_ live_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90708","description":"Measles and rubella virus vaccine_ live_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB07","description":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22850","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB1","description":"ICD-IAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF0","description":"ICD-AGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB1","description":"ICD-JINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26705","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE0","description":"ICD-FEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","description":"HCPCS-G0571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB0","description":"ICD-AIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE234","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED1","description":"ICD-FFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA0","description":"ICD-KGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB0","description":"ICD-CHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE0","description":"ICD-KBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m mebrofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9537","description":"Tc99m mebrofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF0","description":"ICD-KGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protect body sock ea pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0984","description":"Protect body sock ea pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conn tiss_ human(inc fascia)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1762","description":"Conn tiss_ human(inc fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB0","description":"ICD-CAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC0","description":"ICD-CDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6075","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA1","description":"ICD-OHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy lwr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15879","description":"Suction lipectomy lwr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF0","description":"ICD-OCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD0","description":"ICD-HIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE126","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB0","description":"ICD-ICDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug abuse svc nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0047","description":"Alcohol/drug abuse svc nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC0","description":"ICD-CIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA1","description":"ICD-EIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam caster tire any size ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2219","description":"Foam caster tire any size ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37160","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng epi spec sfty issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4330F","description":"Cnslng epi spec sfty issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB0","description":"ICD-JCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC0","description":"ICD-JHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1285","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck t1-t2no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9109","description":"Onc dx head/neck t1-t2no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 80 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1040","description":"Methylprednisolone 80 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skills train and dev_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2014","description":"Skills train and dev_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC0","description":"ICD-MKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF1","description":"ICD-IIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe calip plate exist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3600","description":"Trans shoe calip plate exist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF1","description":"ICD-ICIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB0","description":"ICD-GGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA1","description":"ICD-JIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF0","description":"ICD-NCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA1","description":"ICD-CBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA0","description":"ICD-FAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45341","description":"Sigmoidoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD111","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation cervical mucus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89330","description":"Evaluation cervical mucus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5125","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX41","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy submucous njx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45381","description":"Colonoscopy submucous njx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","description":"HCPCS-G0544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA0","description":"ICD-JBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF1","description":"ICD-FBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB0","description":"ICD-OIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46751","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA1","description":"ICD-KBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA1","description":"ICD-KFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA1","description":"ICD-BAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87562","description":"M.avium-intra dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA1","description":"ICD-OBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE206","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD1","description":"ICD-KFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prior dx/active clin ascvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9662","description":"Prior dx/active clin ascvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Busulfan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0594","description":"Busulfan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sinus tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20500","description":"Injection of sinus tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC1","description":"ICD-EHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA1","description":"ICD-BCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC0","description":"ICD-HEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for salivary x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42550","description":"Injection for salivary x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD0","description":"ICD-CCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF0","description":"ICD-FAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF0","description":"ICD-JAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA0","description":"ICD-CCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis and bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54390","description":"Repair penis and bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE0","description":"ICD-GGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD0","description":"ICD-GEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA0","description":"ICD-DGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/reline occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9942","description":"Repair/reline occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD1","description":"ICD-NDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME0","description":"ICD-GDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC1","description":"ICD-CESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44160","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF1","description":"ICD-LFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB245","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin long acting 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5553","description":"Insulin long acting 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF0","description":"ICD-BAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prenatalcare enhanced srv pk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1005","description":"Prenatalcare enhanced srv pk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF1","description":"ICD-AGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF1","description":"ICD-EGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4563","description":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB0","description":"ICD-ODYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD1","description":"ICD-NCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC0","description":"ICD-NKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB1","description":"ICD-GAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA1","description":"ICD-JAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE0","description":"ICD-LESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC1","description":"ICD-CBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD0","description":"ICD-OCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD0","description":"ICD-HCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0001","description":"Alcohol and/or drug assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Atten goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9166","description":"Atten goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71045","description":"Radiologic examination_ chest; single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA1","description":"ICD-OBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF1","description":"ICD-CHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic custom molded shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5501","description":"Diabetic custom molded shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80336","description":"Antidepressant tricyclic 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15953","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE0","description":"ICD-LBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual field assmnt rev/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378T","description":"Visual field assmnt rev/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB230","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreas lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48120","description":"Removal of pancreas lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0219","description":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not have a caregiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2184","description":"Patient does not have a caregiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coccidioides antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86635","description":"Coccidioides antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF0","description":"ICD-KBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA1","description":"ICD-BGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown lengthen hard tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4249","description":"Crown lengthen hard tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE104","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE0","description":"ICD-KADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk knee joints polycentric p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5677","description":"Bk knee joints polycentric p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC1","description":"ICD-GGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD1","description":"ICD-BCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF1","description":"ICD-NHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodic oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0120","description":"Periodic oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quantalcohols","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80320","description":"Drug screen quantalcohols","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD1","description":"ICD-DESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bld glucose monitor w voice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2100","description":"Bld glucose monitor w voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA0","description":"ICD-HBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE0","description":"ICD-CDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD0","description":"ICD-IGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF1","description":"ICD-NBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","description":"HCPCS-J9038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF0","description":"ICD-EBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB0","description":"ICD-OHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB1","description":"ICD-EFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21435","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF0","description":"ICD-GEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC1","description":"ICD-JALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA1","description":"ICD-ACHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE1","description":"ICD-OEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93986","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23540","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0695T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF0","description":"ICD-JHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF1","description":"ICD-GEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99395","description":"Prev visit est age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF1","description":"ICD-NGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limb exercise test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95875","description":"Limb exercise test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE217","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB1","description":"ICD-GAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE117","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB0","description":"ICD-PFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA1","description":"ICD-EIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1A","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_ programmable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1772","description":"Infusion pump_ programmable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF0","description":"ICD-GFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open reduc compd alveolus fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7770","description":"Open reduc compd alveolus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0403","description":"HCPCS-C0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","description":"HCPCS-Q4423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE1","description":"ICD-DGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB240","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24365","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Formoterol fumarate_ inh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7606","description":"Formoterol fumarate_ inh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disartic switch contro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6960","description":"Shldr disartic switch contro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD0","description":"ICD-AEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB0","description":"ICD-FGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF1","description":"ICD-OBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME1","description":"ICD-IFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis be antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86707","description":"Hepatitis be antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD1","description":"ICD-PGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00802","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","description":"CPT-00802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD1","description":"ICD-DAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sperm duct surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92251","description":"Anesth sperm duct surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB1","description":"ICD-PLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX10","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF1","description":"ICD-NCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB0","description":"ICD-CDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD1","description":"ICD-HIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB0","description":"ICD-AIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA1","description":"ICD-EILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0150","description":"HCPCS-E0150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0860","description":"Pwc gp3 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Massage therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97124","description":"Massage therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD0","description":"ICD-NAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC1","description":"ICD-OFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antistreptolysin o screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86063","description":"Antistreptolysin o screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9025","description":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22515","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA0","description":"ICD-EFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24120","description":"Remove elbow lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA0","description":"ICD-EACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB1","description":"ICD-NJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC1","description":"ICD-GBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0771T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE1","description":"ICD-GEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3502","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD0","description":"ICD-PERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD1","description":"ICD-CDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11470","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF0","description":"ICD-KHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF0","description":"ICD-CGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v index add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88155","description":"Cytopath c/v index add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69915","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relieve pressure on nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64722","description":"Relieve pressure on nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC1","description":"ICD-KEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23172","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD0","description":"ICD-MBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB0","description":"ICD-OJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alveolus clsd reduc stblz te","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7771","description":"Alveolus clsd reduc stblz te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC1","description":"ICD-KDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complex cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51726","description":"Complex cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA0","description":"ICD-LAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF0","description":"ICD-FEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA1","description":"ICD-CGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth facial bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19251","description":"Anesth facial bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open wedge/bx lung nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32097","description":"Open wedge/bx lung nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3388F","description":"Ajcc cln cncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC1","description":"ICD-GDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3A","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC0","description":"ICD-KCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tibper revasc w/ather add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37233","description":"Tibper revasc w/ather add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50690","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE1","description":"ICD-EBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF1","description":"ICD-EIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA0","description":"ICD-BDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215U","description":"RARE DS XOM DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA0","description":"ICD-JDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE0","description":"ICD-NKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB1","description":"ICD-NLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC0","description":"ICD-GAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD1","description":"ICD-KCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC0","description":"ICD-OGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93979","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF0","description":"ICD-KDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF0","description":"ICD-KBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB21","description":"ICD-2JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND1","description":"ICD-BCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbow sequential","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7180","description":"Electronic elbow sequential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8977","description":"Oncology measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0687T","description":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA0","description":"ICD-OLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multipo locking shoulder jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6646","description":"Multipo locking shoulder jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD1","description":"ICD-NACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33952","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0835T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA0","description":"ICD-JBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Volume deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38214","description":"Volume deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103U","description":"Hereditary ovarian cancer (eg_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing a combination of NGS_ Sanger_ MLPA_ and arr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neostim membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4266","description":"Neostim membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA1","description":"ICD-CBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB0","description":"ICD-JGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2373","description":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE0","description":"ICD-LFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3978","description":"Sewhfo airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF0","description":"ICD-JHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0241","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC0","description":"ICD-EIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC0","description":"ICD-OJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcitonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82308","description":"Assay of calcitonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Segmental pneumatic chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0657","description":"Segmental pneumatic chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE0","description":"ICD-EDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD0","description":"ICD-JBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0066U","description":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD1","description":"ICD-CBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0517","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID0","description":"ICD-ODID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA0","description":"ICD-IACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70250","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA1","description":"ICD-IBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","description":"HCPCS-J0167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolong service w/o contact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99358","description":"Prolong service w/o contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF0","description":"ICD-KFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67904","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophilic toric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2521","description":"Cntct lens hydrophilic toric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22853","description":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA1","description":"ICD-OFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB0","description":"ICD-PKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69726","description":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB1","description":"ICD-KHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0683T","description":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","description":"CPT-01922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Int mam art used for cabg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4110F","description":"Int mam art used for cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE0","description":"ICD-OHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF0","description":"ICD-GEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC0","description":"ICD-OESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF1","description":"ICD-KIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26105","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prevocational services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6107","description":"Prevocational services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD1","description":"ICD-LISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC250","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID0","description":"ICD-NFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Basic life disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99450","description":"Basic life disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC0","description":"ICD-GAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF1","description":"ICD-MBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB0","description":"ICD-FBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA0","description":"ICD-JGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc skin abd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15847","description":"Exc skin abd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33411","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA1","description":"ICD-NKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50280","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Full mouth x-ray of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70320","description":"Full mouth x-ray of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE0","description":"ICD-NJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC0","description":"ICD-JDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00176","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","description":"CPT-00176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1260","description":"Wheelchair lightwt foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniotic fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82143","description":"Amniotic fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28296","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID0","description":"ICD-OLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44960","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27080","description":"Removal of tail bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB1","description":"ICD-HESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid exam both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92591","description":"Hearing aid exam both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB1","description":"ICD-FAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5624","description":"Test socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA146","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX36","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB1","description":"ICD-FCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm washing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58323","description":"Sperm washing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA0","description":"ICD-EDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF1","description":"ICD-MHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011M","description":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF1","description":"ICD-NIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37286","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","description":"CPT-37286","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB0","description":"ICD-NEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC150","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Born 1945-1965","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9448","description":"Born 1945-1965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant auditory brain imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2235","description":"Implant auditory brain imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD0","description":"ICD-LDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC1","description":"ICD-GCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67505","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD154","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artificial saliva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9155","description":"Artificial saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1044T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1044T","description":"CPT-1044T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61640","description":"Dilate ic vasospasm init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE1","description":"ICD-NBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA1","description":"ICD-OIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB1","description":"ICD-LEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA1","description":"ICD-AEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim other than wound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0283","description":"Elec stim other than wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92558","description":"Evoked auditory test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB40","description":"High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52000","description":"Cystoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF1","description":"ICD-GAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1343","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD1","description":"ICD-LASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE0","description":"ICD-EELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB1","description":"ICD-NGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9758","description":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zoledronic acid 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3489","description":"Zoledronic acid 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23065","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE0","description":"ICD-KIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF1","description":"ICD-NGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB0","description":"ICD-GDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD0","description":"ICD-NDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4B","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33979","description":"Insert intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB0","description":"ICD-BFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA1","description":"ICD-IITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC0","description":"ICD-FCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50549","description":"Laparoscope proc renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME0","description":"ICD-JAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF0","description":"ICD-IIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD0","description":"ICD-NGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE0","description":"ICD-KHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99441","description":"Phone e/m phys/qhp 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA0","description":"ICD-BFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cus elbo skt in not con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6697","description":"Cus elbo skt in not con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB0","description":"ICD-DDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3471","description":"Surgical repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA225","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8A","description":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD1","description":"ICD-LARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81417","description":"Exome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF1","description":"ICD-NEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC0","description":"ICD-OLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 3mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0462","description":"Tlso 3mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1803","description":"CDT-D1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC11","description":"ICD-3EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx platelet plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232T","description":"Njx platelet plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1302","description":"HCPCS-A1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED1","description":"ICD-FIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB0","description":"ICD-KDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA1","description":"ICD-JHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Axillary crutch extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0978","description":"Axillary crutch extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60212","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0738T","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chorion biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59015","description":"Chorion biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX20","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE0","description":"ICD-BFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES126","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE1","description":"ICD-AFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD1","description":"ICD-NFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61601","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC0","description":"ICD-CDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abut support retainer titani","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6194","description":"Abut support retainer titani","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD1","description":"ICD-KFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59618","description":"Attempted vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38101","description":"Removal of spleen partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB1","description":"ICD-CFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60540","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF1","description":"ICD-OCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD0","description":"ICD-NJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont chem diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9330","description":"Hit cont chem diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA1","description":"ICD-KERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID0","description":"ICD-OAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric mucosa imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78261","description":"Gastric mucosa imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint repl 2 pc or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8631","description":"Mcp joint repl 2 pc or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF0","description":"ICD-HCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF0","description":"ICD-NKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0501","description":"HCPCS-C0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD1","description":"ICD-ACUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD1","description":"ICD-FCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC0","description":"ICD-AGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA0","description":"ICD-MBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv semi-rig adj molded chn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0150","description":"Cerv semi-rig adj molded chn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ taliglucerase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3060","description":"Injection_ taliglucerase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC1","description":"ICD-OBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29894","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES130","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE0","description":"ICD-JGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA1","description":"ICD-KCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB33","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC1","description":"ICD-IHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supply_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5999","description":"Supply_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0038U","description":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB250","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB51","description":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND0","description":"ICD-NAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF1","description":"ICD-HAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48551","description":"Prep donor pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9322","description":"No doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF1","description":"ICD-FDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF0","description":"ICD-PKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD0","description":"ICD-NJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA0","description":"ICD-OCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB1","description":"ICD-BIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB1","description":"ICD-PFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD0","description":"ICD-DCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hand surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26250","description":"Extensive hand surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lip surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40799","description":"Lip surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND0","description":"ICD-OGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB1","description":"ICD-KHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD1","description":"ICD-HISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompressive craniotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61322","description":"Decompressive craniotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD0","description":"ICD-CEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38720","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA0","description":"ICD-GIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levamisole 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0177","description":"Levamisole 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA0","description":"ICD-KGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49187","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","description":"CPT-49187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5A","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12017","description":"Rpr fe/e/en/l/m 20.1-30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF0","description":"ICD-NGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB0","description":"ICD-GEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE0","description":"ICD-NCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE241","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA1","description":"ICD-OFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","description":"HCPCS-Q4421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE0","description":"ICD-LARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ldct for lung ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0297","description":"Ldct for lung ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF0","description":"ICD-IICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD0","description":"ICD-EDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC0","description":"ICD-HFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl 11-12.9 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3280F","description":"Hgb lvl 11-12.9 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5697","description":"Ak/knee disartic pelvic band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC1","description":"ICD-GDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF0","description":"ICD-OFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject skin lesions ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73552","description":"X-ray exam of femur 2/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0132","description":"Acetylcysteine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD1","description":"ICD-ECAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC11","description":"ICD-4LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56632","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF1","description":"ICD-JGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc lack perm&cont&parox fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1061F","description":"Doc lack perm&cont&parox fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49495","description":"Rpr ing hernia baby reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL55","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF1","description":"ICD-BFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF1","description":"ICD-MLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB1","description":"ICD-CALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF1","description":"ICD-MHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD155","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD0","description":"ICD-HFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD1","description":"ICD-GEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA0","description":"ICD-OEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE0","description":"ICD-LIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB0","description":"ICD-NIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6580","description":"Gradient compression glove_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB121","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD0","description":"ICD-GGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF0","description":"ICD-OJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27601","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD0","description":"ICD-EBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD0","description":"ICD-OIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/12-2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2107","description":"Spherocylinder 4.25d/12-2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ue fx orth shoul cap forearm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3981","description":"Ue fx orth shoul cap forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2022","description":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88309","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD1","description":"ICD-FFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36013","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD1","description":"ICD-OJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9928","description":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63180","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC1","description":"ICD-NJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC1","description":"ICD-DEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF0","description":"ICD-FCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2095","description":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2251","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"D5w infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7070","description":"D5w infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26608","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE0","description":"ICD-GIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF1","description":"ICD-JDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No hepc rna after med docrsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9210","description":"No hepc rna after med docrsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE0","description":"ICD-BFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD1","description":"ICD-IFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","description":"CPT-01404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD0","description":"ICD-GBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF1","description":"ICD-NCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone undecanoate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3145","description":"Testosterone undecanoate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0612","description":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA231","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB1","description":"ICD-KHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57240","description":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1108T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1108T","description":"CPT-1108T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical revision procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4268","description":"Surgical revision procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF0","description":"ICD-KIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC1","description":"ICD-LIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF0","description":"ICD-OBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC0","description":"ICD-OLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE1","description":"ICD-KAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA1","description":"ICD-GHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46604","description":"Anoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tint photochromatic lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2744","description":"Tint photochromatic lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC1","description":"ICD-FADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC0","description":"ICD-JHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fungi identification yeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87106","description":"Fungi identification yeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF1","description":"ICD-OLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC0","description":"ICD-JHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB0","description":"ICD-JCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96933","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlude fallopian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58615","description":"Occlude fallopian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB1","description":"ICD-OBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC1","description":"ICD-BGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB1","description":"ICD-IIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA1","description":"ICD-CFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF1","description":"ICD-MKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obtaining screen pap smear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0091","description":"Obtaining screen pap smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE0","description":"ICD-MJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC0","description":"ICD-ODTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC1","description":"ICD-JAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45349","description":"Sigmoidoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic deluxe shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5508","description":"Diabetic deluxe shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of aphasia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96105","description":"Assessment of aphasia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0540","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","description":"HCPCS-G0540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knee 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73560","description":"X-ray exam of knee 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99363","description":"Anticoagulant mgmt initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8H","description":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD0","description":"ICD-OFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF1","description":"ICD-GCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA0","description":"ICD-PLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF1","description":"ICD-JEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9898","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF0","description":"ICD-CHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB0","description":"ICD-OLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4174","description":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27479","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA1","description":"ICD-KDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance waiting 1/2 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0420","description":"Ambulance waiting 1/2 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC0","description":"ICD-KAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE0","description":"ICD-OCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD1","description":"ICD-CAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE1","description":"ICD-MGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","description":"HCPCS-J0738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43290","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF1","description":"ICD-NJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD116","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9976","description":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Es sph augmnt device removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393T","description":"Es sph augmnt device removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC0","description":"ICD-CDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA1","description":"ICD-CEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67710","description":"Incision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99492","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA0","description":"ICD-NIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd accessory_ mounting sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2512","description":"Sgd accessory_ mounting sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ziv-aflibercept_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9400","description":"Inj_ ziv-aflibercept_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toilet seat raised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0244","description":"Toilet seat raised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE0","description":"ICD-FHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture complete mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5865","description":"Overdenture complete mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8H","description":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB0","description":"ICD-AIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE0","description":"ICD-AGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c rna 4to12 wk after med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9209","description":"Hep c rna 4to12 wk after med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC0","description":"ICD-ABCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA0","description":"ICD-AIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD1","description":"ICD-FGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD1","description":"ICD-CAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC1","description":"ICD-OLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90833","description":"Psytx pt&/fam w/e&m 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ clevidipine butyrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9248","description":"Inj_ clevidipine butyrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74251","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28545","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC0","description":"ICD-CFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF1","description":"ICD-LIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16070","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16070","description":"CPT-16070","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC221","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1050","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC1","description":"ICD-IGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xm archive tissue molec anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88363","description":"Xm archive tissue molec anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF0","description":"ICD-KFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81274","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37232","description":"Tib/per revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF0","description":"ICD-HGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE1","description":"ICD-OISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC43","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE1","description":"ICD-OKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0579T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF0","description":"ICD-BFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF0","description":"ICD-KADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen gel/paste wound fil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6011","description":"Collagen gel/paste wound fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA0","description":"ICD-PFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB1","description":"ICD-OEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med reas rpt no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9423","description":"Med reas rpt no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2054","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine bacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87088","description":"Urine bacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF0","description":"ICD-KDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv musc neck dyston","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64616","description":"Chemodenerv musc neck dyston","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB0","description":"ICD-ECDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC1","description":"ICD-LBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC1","description":"ICD-CEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0302","description":"Pre-op service lvrs complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD0","description":"ICD-FHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tacrol envarsus ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7503","description":"Tacrol envarsus ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF0","description":"ICD-NENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill-brachial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35522","description":"Art byp grft axill-brachial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5C","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE0","description":"ICD-MKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE0","description":"ICD-OFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3380F","description":"Ajcc brstcncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA21","description":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES146","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB0","description":"ICD-NHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD1","description":"ICD-EGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC0","description":"ICD-CFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of folic acid rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82747","description":"Assay of folic acid rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7514","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53025","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78266","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33241","description":"Remove pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pp eval/edu not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9358","description":"Pp eval/edu not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC1","description":"ICD-LFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEF0","description":"ICD-JGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD0","description":"ICD-OESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA0","description":"ICD-OAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1032","description":"Nonpneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abd&pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74174","description":"Ct angio abd&pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40843","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2210","description":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy head&neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15876","description":"Suction lipectomy head&neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC217","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54620","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0567T","description":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB1","description":"ICD-KDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC0","description":"ICD-GHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD1","description":"ICD-OHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9509","description":"Iodine i-123 sod iodide mil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB0","description":"ICD-MAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA0","description":"ICD-CFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m gluceptate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9550","description":"Tc99m gluceptate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437T","description":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA1","description":"ICD-PIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiofq trsmtr for implt neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8683","description":"Radiofq trsmtr for implt neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ndl aspir/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44407","description":"Colonoscopy w/ndl aspir/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40820","description":"Treatment of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF0","description":"ICD-DCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","description":"CPT-00756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC0","description":"ICD-OBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Underarm springassist crutch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0117","description":"Underarm springassist crutch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28046","description":"Resect foot/toe tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB1","description":"ICD-GEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA0","description":"ICD-FFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA1","description":"ICD-IDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84207","description":"Assay of vitamin b-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA0","description":"ICD-HIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC0","description":"ICD-GAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81300","description":"Msh6 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0701","description":"HCPCS-C0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin_ drug-coat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2623","description":"Cath_ translumin_ drug-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2174","description":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB1","description":"ICD-IHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD0","description":"ICD-OCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB1","description":"ICD-HHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD1","description":"ICD-FDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA1","description":"ICD-AELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC1","description":"ICD-CCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgigraft-dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4219","description":"Surgigraft-dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD0","description":"ICD-EFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE1","description":"ICD-OHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4228","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4228","description":"HCPCS-A4228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE1","description":"ICD-AHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC1","description":"ICD-CGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB0","description":"ICD-GFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC1","description":"ICD-KINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD1","description":"ICD-NDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breast surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19499","description":"Breast surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27498","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB1","description":"ICD-MIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB0","description":"ICD-GCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA21","description":"ICD-4BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27831","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amiodarone hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0282","description":"Amiodarone hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20975","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB1","description":"ICD-FCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86316","description":"Immunoassay tumor other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Velaglucerase alfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3385","description":"Velaglucerase alfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD1","description":"ICD-NJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF1","description":"ICD-FHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Varicella-zoster ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90396","description":"Varicella-zoster ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy volvul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45321","description":"Proctosigmoidoscopy volvul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21122","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID0","description":"ICD-EAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86005","description":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF0","description":"ICD-KAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2315","description":"Lens lenticular trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sperm duct(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55250","description":"Removal of sperm duct(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47133","description":"Removal of donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt w out cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9241","description":"Doc pt w out cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling catheter latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4338","description":"Indwelling catheter latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF0","description":"ICD-BELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines1-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80346","description":"Benzodiazepines1-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC1","description":"ICD-CBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cultr bacteria except blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87075","description":"Cultr bacteria except blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late closure of wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13160","description":"Late closure of wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF1","description":"ICD-MLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC1","description":"ICD-GHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35102","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polycarb lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0580","description":"Polycarb lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewho cap design w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3971","description":"Sewho cap design w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID0","description":"ICD-NKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443T","description":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244T","description":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flu immunize no admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8484","description":"Flu immunize no admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9626","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92975","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB0","description":"ICD-IGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE0","description":"ICD-IGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID0","description":"ICD-MFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74247","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE0","description":"ICD-OLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB1","description":"ICD-BEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB1","description":"ICD-KDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9754","description":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB1","description":"ICD-GBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB0","description":"ICD-NBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0204","description":"HCPCS-B0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trnscrv uterin fibroid abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404T","description":"Trnscrv uterin fibroid abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB0","description":"ICD-KGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF0","description":"ICD-GCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX40","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE1","description":"ICD-BAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27394","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC1","description":"ICD-GFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC1","description":"ICD-KGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF0","description":"ICD-GCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0303","description":"HCPCS-B0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE0","description":"ICD-DEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","description":"HCPCS-J1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES256","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB0","description":"ICD-IEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0793T","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD0","description":"ICD-ACLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE1","description":"ICD-KIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD224","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC1","description":"ICD-OCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF0","description":"ICD-NDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD0","description":"ICD-BHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0554","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","description":"HCPCS-G0554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE0","description":"ICD-EEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51860","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45135","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID0","description":"ICD-FHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266U","description":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair solid seat insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0992","description":"Wheelchair solid seat insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE0","description":"ICD-OLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limit oral eval problm focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0140","description":"Limit oral eval problm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA0","description":"ICD-KHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF0","description":"ICD-NDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD1","description":"ICD-NLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38550","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC1","description":"ICD-BAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immed max part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5221","description":"Immed max part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB0","description":"ICD-PBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0601","description":"HCPCS-A0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE213","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21147","description":"Lefort i-3/> piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4721","description":"Dialysat sol fld vol > 999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF1","description":"ICD-JGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE1","description":"ICD-FAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF1","description":"ICD-DAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58900","description":"Biopsy of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4100","description":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE1","description":"ICD-OEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DI GNOTYP SLC4A1 EXON 19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0183U","description":"DI GNOTYP SLC4A1 EXON 19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE0","description":"ICD-OLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lyse chest fibrin init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32561","description":"Lyse chest fibrin init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB22","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measure venous pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93770","description":"Measure venous pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF1","description":"ICD-AITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC0","description":"ICD-GCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial plast molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5560","description":"Prep ak ischial plast molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE0","description":"ICD-OJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF1","description":"ICD-BDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD0","description":"ICD-LAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC1","description":"ICD-CHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE1","description":"ICD-NCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69205","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE0","description":"ICD-CAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr pck base combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0489","description":"Pwr pck base combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1904","description":"HCPCS-A1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC0","description":"ICD-NIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF0","description":"ICD-OGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72131","description":"Ct lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC1","description":"ICD-LCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF1","description":"ICD-JFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA1","description":"ICD-KHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disease progn ra good docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3476F","description":"Disease progn ra good docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE1","description":"ICD-KHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB0","description":"ICD-EGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE0","description":"ICD-IFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9247","description":"Injection_ melphalan flufenamide_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet image ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78811","description":"Pet image ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE1","description":"ICD-FHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N-et; encounter/trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2003","description":"N-et; encounter/trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung volume reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32491","description":"Lung volume reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77499","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0857","description":"Pwc gp3 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crutch forearm pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0110","description":"Crutch forearm pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA125","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaporizer room type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0605","description":"Vaporizer room type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA25","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES304","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28107","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF1","description":"ICD-NDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA1","description":"ICD-LAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF0","description":"ICD-OJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF1","description":"ICD-NEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB0","description":"ICD-KGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF0","description":"ICD-PLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine maleate 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0164","description":"Prochlorperazine maleate 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB1","description":"ICD-OACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA1","description":"ICD-JCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC201","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF1","description":"ICD-HHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bronchus add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32501","description":"Repair bronchus add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF0","description":"ICD-FBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling trach insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8511","description":"Indwelling trach insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1009","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81375","description":"Hla ii typing ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF0","description":"ICD-KBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9628","description":"Vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC0","description":"ICD-ICIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB0","description":"ICD-GGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar between","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3410","description":"Shoe metatarsal bar between","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB1","description":"ICD-OLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA0","description":"ICD-OEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD0","description":"ICD-ODXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB0","description":"ICD-NCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE1","description":"ICD-FGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF0","description":"ICD-LASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA0","description":"ICD-MBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB1","description":"ICD-FEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE0","description":"ICD-OLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg >16<=48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0745","description":"Absorp drg >16<=48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD0","description":"ICD-FFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237U","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86807","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70220","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF0","description":"ICD-CGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE0","description":"ICD-KFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles compound lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92355","description":"Fit spectacles compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF1","description":"ICD-FIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA21","description":"ICD-2DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB0","description":"ICD-OKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nose allergy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95065","description":"Nose allergy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA0","description":"ICD-OCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23680","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF1","description":"ICD-FFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF1","description":"ICD-IELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7177","description":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop ultrasound exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43231","description":"Esophagoscop ultrasound exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9800","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporine oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7515","description":"Cyclosporine oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD0","description":"ICD-NATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE0","description":"ICD-MAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87183","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","description":"CPT-87183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340U","description":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8953","description":"Oncology mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I125 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9532","description":"I125 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE1","description":"ICD-CIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC1","description":"ICD-CCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate (Xatmep)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8612","description":"Methotrexate (Xatmep)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD0","description":"ICD-OAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB0","description":"ICD-JCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9880","description":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437U","description":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF1","description":"ICD-KBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF1","description":"ICD-NHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56740","description":"Remove vagina gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA0","description":"ICD-FIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50695","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi blw low param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8418","description":"Calc bmi blw low param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB0","description":"ICD-NEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0669U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0669U","description":"CPT-0669U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC0","description":"ICD-HAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB1","description":"ICD-NIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0593T","description":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF0","description":"ICD-IFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD1","description":"ICD-MFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56651","description":"Anesth cabg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3378F","description":"Ajcc brstcncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52275","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES230","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC0","description":"ICD-ACCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psa/t/glsc docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3268F","description":"Psa/t/glsc docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE1","description":"ICD-HDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin for insulin pump use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1817","description":"Insulin for insulin pump use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA1","description":"ICD-ODSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD1","description":"ICD-OJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36640","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61571","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87850","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED1","description":"ICD-GCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0086","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37295","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","description":"CPT-37295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plan 2 main dr by 1 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5050F","description":"Plan 2 main dr by 1 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-osseointegrated snd proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8692","description":"Non-osseointegrated snd proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE1","description":"ICD-HHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear antigen antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86235","description":"Nuclear antigen antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF0","description":"ICD-IIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND0","description":"ICD-KFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE0","description":"ICD-MBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD1","description":"ICD-CCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB1","description":"ICD-GEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1290","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD0","description":"ICD-NLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE0","description":"ICD-OBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF1","description":"ICD-MCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD0","description":"ICD-AHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9275","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","description":"HCPCS-J9275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","description":"HCPCS-M1393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6539","description":"Gc stocking waistlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen meniscus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0428","description":"Collagen meniscus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt immunity to hep a docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3215F","description":"Pt immunity to hep a docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB1","description":"ICD-LHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE0","description":"ICD-CAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE255","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual fully reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1226","description":"Manual fully reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB0","description":"ICD-FHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC0","description":"ICD-FHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD1","description":"ICD-BFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngeal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92520","description":"Laryngeal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD0","description":"ICD-EGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9078","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97168","description":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9517","description":"No impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF1","description":"ICD-MDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB0","description":"ICD-BDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC1","description":"ICD-KECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE0","description":"ICD-NKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening oxycodone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80365","description":"Drug screening oxycodone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC1","description":"ICD-OAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0554","description":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413T","description":"Rmvl car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF1","description":"ICD-IBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93225","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD0","description":"ICD-NJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","description":"HCPCS-J8502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF0","description":"ICD-JDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF1","description":"ICD-CHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF0","description":"ICD-EDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sps ankle device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1816","description":"Sps ankle device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA0","description":"ICD-MFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD0","description":"ICD-MLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA1","description":"ICD-GBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medrsn >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9353","description":"Medrsn >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat trigeminal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61791","description":"Treat trigeminal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0A","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC1","description":"ICD-OCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC0","description":"ICD-BCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75968","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD0","description":"ICD-CHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of topiramate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80201","description":"Assay of topiramate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9762","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special stains group 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88312","description":"Special stains group 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1038T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1038T","description":"CPT-1038T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m labeled rbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9560","description":"Tc99m labeled rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA10","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crwn pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2930","description":"Prefab stnlss steel crwn pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3 comp foot exam completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9226","description":"3 comp foot exam completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA0","description":"ICD-NJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB0","description":"ICD-CHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21183","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB215","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB0","description":"ICD-EEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3406","description":"HCPCS-J3406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mon anesth care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9654","description":"Mon anesth care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97551","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC0","description":"ICD-OBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB1","description":"ICD-IIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE1","description":"ICD-NKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA1","description":"ICD-BGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67107","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat vagina infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57150","description":"Treat vagina infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride skin musc at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11011","description":"Debride skin musc at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA1","description":"ICD-CDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef < 40% or lvsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8923","description":"Lvef < 40% or lvsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB0","description":"ICD-GHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5620","description":"Test socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine process addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172T","description":"Lumbar spine process addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF1","description":"ICD-OALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC1","description":"ICD-BDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB1","description":"ICD-OCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration - resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6106","description":"guided tissue regeneration - resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD1","description":"ICD-IDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD1","description":"ICD-KBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA21","description":"ICD-4KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1015T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","description":"CPT-1015T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB1","description":"ICD-NFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC0","description":"ICD-JFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC21","description":"ICD-2FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC0","description":"ICD-IEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte f-up or lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93308","description":"Tte f-up or lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8652","description":"Fun stat score hip < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1334","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5228","description":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD0","description":"ICD-BIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF1","description":"ICD-GEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27860","description":"Fixation of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0313","description":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove rectal obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45915","description":"Remove rectal obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1136","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA1","description":"ICD-CDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9310","description":"Unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA1","description":"ICD-GGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD0","description":"ICD-NLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD0","description":"ICD-CFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7626","description":"Budesonide non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin (khapzory)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0642","description":"Injection_ levoleucovorin (khapzory)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF0","description":"ICD-CGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316U","description":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46612","description":"Anoscopy remove lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE1","description":"ICD-MKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB0","description":"ICD-BEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF0","description":"ICD-OGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF0","description":"ICD-KBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB116","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80340","description":"Antiepileptics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3B","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX31","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF0","description":"ICD-FDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF0","description":"ICD-BDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF0","description":"ICD-OKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF0","description":"ICD-KGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA0","description":"ICD-FHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0524U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","description":"CPT-0524U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC0","description":"ICD-DDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC1","description":"ICD-KIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA0","description":"ICD-FGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB0","description":"ICD-FAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62328","description":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC0","description":"ICD-IBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF1","description":"ICD-KINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA0","description":"ICD-OLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF0","description":"ICD-FGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oseltamivir phosp_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9035","description":"Oseltamivir phosp_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2A","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7196","description":"Antithrombin recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB1","description":"ICD-MKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6252","description":"Bridge resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC1","description":"ICD-MHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA1","description":"ICD-BFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA0","description":"ICD-ICTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF1","description":"ICD-ABLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB1","description":"ICD-CCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj extensive retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67227","description":"Dstrj extensive retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF0","description":"ICD-JEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOST_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4328","description":"MOST_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB1","description":"ICD-JDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","description":"CPT-01830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD0","description":"ICD-KFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rad w/o backup non-inv intfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0470","description":"Rad w/o backup non-inv intfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation syringe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4322","description":"Irrigation syringe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC1","description":"ICD-CHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8X","description":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC1","description":"ICD-BGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deionizer h2o puri system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1615","description":"Deionizer h2o puri system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE255","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC1","description":"ICD-GHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC0","description":"ICD-CDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE0","description":"ICD-CCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB1","description":"ICD-GAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE1","description":"ICD-BAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC1","description":"ICD-BCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61458","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA0","description":"ICD-GDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF1","description":"ICD-CFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr att- conv 1 arm drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0958","description":"Whlchr att- conv 1 arm drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9761","description":"Cystourethroscopy_ with ureteroscopy and/or pyeloscopy_ with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney_ collecting system and uret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF1","description":"ICD-PKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB0","description":"ICD-EGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF1","description":"ICD-JILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77058","description":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"22nf sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2361","description":"22nf sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC1","description":"ICD-FIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7526","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7526","description":"HCPCS-J7526","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB0","description":"ICD-FEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC0","description":"ICD-FIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73540","description":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB1","description":"ICD-AIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0648T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC1","description":"ICD-BEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelv & thor control gluteal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2650","description":"Pelv & thor control gluteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19125","description":"Excision breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1087T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1087T","description":"CPT-1087T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE1","description":"ICD-OIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF1","description":"ICD-NAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/pat by hc prof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99366","description":"Team conf w/pat by hc prof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD1","description":"ICD-PDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD1","description":"ICD-BEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC10","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA1","description":"ICD-NEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC0","description":"ICD-KFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF0","description":"ICD-HIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0008","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57400","description":"Dilation of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening for sleep related breathing disorders","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9957","description":"Screening for sleep related breathing disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma not detect screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3776F","description":"Adenoma not detect screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF0","description":"ICD-JHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF0","description":"ICD-BCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD0","description":"ICD-OLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC0","description":"ICD-AFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA1","description":"ICD-LDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43772","description":"Lap rmvl gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF1","description":"ICD-AFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD1","description":"ICD-NDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA1","description":"ICD-IIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF1","description":"ICD-GAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD0","description":"ICD-KGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE1","description":"ICD-OIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainable rubber pch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4376","description":"Drainable rubber pch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB0","description":"ICD-JFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth intrcrn nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22051","description":"Anesth intrcrn nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE1","description":"ICD-FCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA10","description":"Default_ /5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC1","description":"ICD-JDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE1","description":"ICD-ECBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD0","description":"ICD-CEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB1","description":"ICD-GCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33250","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES315","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81271","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject trigger points 3/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20553","description":"Inject trigger points 3/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF0","description":"ICD-NEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF0","description":"ICD-JDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bcg vaccine percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90585","description":"Bcg vaccine percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB0","description":"ICD-DGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF0","description":"ICD-OLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC0","description":"ICD-IIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restore/remodel ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33548","description":"Restore/remodel ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA1","description":"ICD-BILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF1","description":"ICD-GEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dtap vaccine < 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90700","description":"Dtap vaccine < 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF0","description":"ICD-FCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA1","description":"ICD-JCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC1","description":"ICD-GBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD0","description":"ICD-CBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD0","description":"ICD-MHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0992T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","description":"CPT-0992T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22114","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB0","description":"ICD-MBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA1","description":"ICD-HASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF0","description":"ICD-NEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7314","description":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD1","description":"ICD-CILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrst mld sck flx hng tri pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6050","description":"Wrst mld sck flx hng tri pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED1","description":"ICD-EAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE1","description":"ICD-IAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC1","description":"ICD-GASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not trans to hosp at d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8915","description":"Pt not trans to hosp at d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phoenix wound matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2015","description":"Phoenix wound matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB126","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Beta-bloc rx pt w/abn lvef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8450","description":"Beta-bloc rx pt w/abn lvef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL44","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD1","description":"ICD-OKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB1","description":"ICD-FEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD1","description":"ICD-BABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58925","description":"Removal of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1119","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB1","description":"ICD-CAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54405","description":"Insert multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prostatectomy (turp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52601","description":"Prostatectomy (turp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF1","description":"ICD-GAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF1","description":"ICD-AEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE0","description":"ICD-NHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27580","description":"Fusion of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj theophylline per 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2810","description":"Inj theophylline per 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54901","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD1","description":"ICD-AEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML56","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF1","description":"ICD-EAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Frozen Entree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1760","description":"Home Delivered Meals-Frozen Entree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB0","description":"ICD-JIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1502","description":"HCPCS-C1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51800","description":"Revision of bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 tositumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9544","description":"I131 tositumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES224","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complement total (ch50)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86162","description":"Complement total (ch50)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE1","description":"ICD-HARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE1","description":"ICD-GFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neurostim arrays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61886","description":"Implant neurostim arrays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1289","description":"HCPCS-J1289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4339","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","description":"HCPCS-Q4339","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF1","description":"ICD-MGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA1","description":"ICD-IHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD0","description":"ICD-KIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD1","description":"ICD-FBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA1","description":"ICD-KHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF0","description":"ICD-KDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB1","description":"ICD-ACHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ABO GNOTYP NEXT GNRJ SEQ ABO","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221U","description":"ABO GNOTYP NEXT GNRJ SEQ ABO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE1","description":"ICD-FIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"So vest canvas/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3675","description":"So vest canvas/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC1","description":"ICD-FDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0613U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","description":"CPT-0613U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","description":"HCPCS-Q4437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC1","description":"ICD-FEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF0","description":"ICD-ODUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81175","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procenta_ per 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4244","description":"Procenta_ per 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC0","description":"ICD-OINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA0","description":"ICD-NEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC0","description":"ICD-GAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC1","description":"ICD-GCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of hypotony","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1326","description":"Patients with a diagnosis of hypotony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD0","description":"ICD-NIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tisotumab vedotin-tftv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9273","description":"Injection_ tisotumab vedotin-tftv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF0","description":"ICD-GEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat width 24-27 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2202","description":"Seat width 24-27 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB0","description":"ICD-DISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE1","description":"ICD-AGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace pretibial shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4130","description":"Replace pretibial shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9455","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close bladder-uterus fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51920","description":"Close bladder-uterus fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD0","description":"ICD-GIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF1","description":"ICD-AHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD1","description":"ICD-GFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF0","description":"ICD-NKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA1","description":"ICD-CEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF0","description":"ICD-GFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9089","description":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB0","description":"ICD-CEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Youth size pull-on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4534","description":"Youth size pull-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE0","description":"ICD-JIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB1","description":"ICD-MCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB1","description":"ICD-NCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE0","description":"ICD-KDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE1","description":"ICD-JEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31295","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA1","description":"ICD-JBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9762","description":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB0","description":"ICD-ADIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hexa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81255","description":"Hexa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD1","description":"ICD-CDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB1","description":"ICD-KFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF1","description":"ICD-KDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doxepin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6034","description":"Doxepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28293","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC11","description":"ICD-2HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA33","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA0","description":"ICD-CHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","description":"HCPCS-M1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC1","description":"ICD-KEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90955","description":"Esrd srv 2-3 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High mount flip-up footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0037","description":"High mount flip-up footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC0","description":"ICD-GICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids natural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80349","description":"Cannabinoids natural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF1","description":"ICD-GHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE0","description":"ICD-JDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Straight tip urine catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4351","description":"Straight tip urine catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0532T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90381","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF0","description":"ICD-KFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0755T","description":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA1","description":"ICD-JGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC1","description":"ICD-JELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC1","description":"ICD-GIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB0","description":"ICD-EABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC0","description":"ICD-EDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9306","description":"Interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF0","description":"ICD-MCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF1","description":"ICD-NKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB0","description":"ICD-AFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nocardia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86744","description":"Nocardia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA41","description":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB0","description":"ICD-BEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC0","description":"ICD-BFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2643","description":"Brachytx_ non-stranded_c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0603","description":"HCPCS-B0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1 or no ct sinus w/in 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9354","description":"1 or no ct sinus w/in 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC0","description":"ICD-HGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE1","description":"ICD-OFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta phys/qhp ea 30d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0606T","description":"Rem oct rta phys/qhp ea 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC1","description":"ICD-KDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE1","description":"ICD-ODHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part remove hip bone super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27070","description":"Part remove hip bone super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB0","description":"ICD-KIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0664","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","description":"HCPCS-G0664","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF0","description":"ICD-ADDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC13","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3A","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC0","description":"ICD-OKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC0","description":"ICD-OKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD0","description":"ICD-NKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB0","description":"ICD-FDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40451","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE0","description":"ICD-JITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC21","description":"ICD-4HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA0","description":"ICD-AHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40701","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt referral psych docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4062F","description":"Pt referral psych docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX34","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81301","description":"Microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB16","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gated heart planar single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78472","description":"Gated heart planar single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7611","description":"Albuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD220","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC22","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB1","description":"ICD-MKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peritoneal dialysis clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1634","description":"Peritoneal dialysis clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC0","description":"ICD-MLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF0","description":"ICD-NEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath closure of asd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93580","description":"Transcath closure of asd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair fibula nonunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27726","description":"Repair fibula nonunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA1","description":"ICD-GDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reusable nipple prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8032","description":"Reusable nipple prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC1","description":"ICD-KCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE1","description":"ICD-KAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA1","description":"ICD-DFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC1","description":"ICD-LCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow aspirate &biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0364","description":"Bone marrow aspirate &biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49591","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58294","description":"Vag hyst w/enterocele compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC1","description":"ICD-GEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC1","description":"ICD-OBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD1","description":"ICD-OFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF1","description":"ICD-MLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58950","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryocautery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57511","description":"Cryocautery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9399","description":"Doc disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA0","description":"ICD-CIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC1","description":"ICD-NKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intens behave ther cardio dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0446","description":"Intens behave ther cardio dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD1","description":"ICD-OEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB50","description":"Very High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99493","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43212","description":"Esophagoscop stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2615","description":"Pos back post/lat wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mouth surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40899","description":"Mouth surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC1","description":"ICD-NAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97127","description":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA0","description":"ICD-IATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","description":"HCPCS-L6029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vivaglobin_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1562","description":"Vivaglobin_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9940","description":"Dental occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA1","description":"ICD-LBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC0","description":"ICD-OBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB1","description":"ICD-CCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA0","description":"ICD-FFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychosocial rehabilitation services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2017","description":"Psychosocial rehabilitation services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD1","description":"ICD-OJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1224","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0503","description":"HCPCS-B0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC0","description":"ICD-CCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC1","description":"ICD-FHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD125","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID0","description":"ICD-NIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC1","description":"ICD-GFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA1","description":"ICD-FAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD0","description":"ICD-OIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF1","description":"ICD-CEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorac cont lat support upri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2680","description":"Thorac cont lat support upri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC1","description":"ICD-CCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF0","description":"ICD-MKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF1","description":"ICD-NKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69970","description":"Remove inner ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE0","description":"ICD-BDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temp fml iu vlv-pmp 1st insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0596T","description":"Temp fml iu vlv-pmp 1st insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg (Tecentriq)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9483","description":"Injection_ atezolizumab_ 10 mg (Tecentriq)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC1","description":"ICD-CFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53621","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC1","description":"ICD-GESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA1","description":"ICD-FEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB0","description":"ICD-IIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF1","description":"ICD-OJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35565","description":"Art byp grft iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop mucosal resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43211","description":"Esophagoscop mucosal resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE1","description":"ICD-GFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Romidepsin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9315","description":"Romidepsin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF0","description":"ICD-NHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME1","description":"ICD-JCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC0","description":"ICD-PAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0658T","description":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB1","description":"ICD-IDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF1","description":"ICD-IDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA1","description":"ICD-ABUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB0","description":"ICD-KDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift hydraulic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0630","description":"Patient lift hydraulic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB0","description":"ICD-LGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbt/fac/nck w/o &w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70543","description":"MRI orbt/fac/nck w/o &w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB1","description":"ICD-OFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0197","description":"Air pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pild/placebo control clin tr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0276","description":"Pild/placebo control clin tr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0634T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD1","description":"ICD-GBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA0","description":"ICD-OHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peroneal straps pair pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0980","description":"Peroneal straps pair pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20005","description":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC0","description":"ICD-LBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE0","description":"ICD-NAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA0","description":"ICD-KEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87529","description":"Hsv dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC1","description":"ICD-AGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF1","description":"ICD-OFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE1","description":"ICD-OLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94618","description":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Con tissue w dble ped graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4276","description":"Con tissue w dble ped graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer non-mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2530","description":"Thigh/wght bear lacer non-mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8720","description":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57300","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/create pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51596","description":"Remove bladder/create pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC0","description":"ICD-JBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mis sup/ac imp vad nopay med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0509","description":"Mis sup/ac imp vad nopay med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung cx bx rpt no doc class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9421","description":"Lung cx bx rpt no doc class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD0","description":"ICD-OIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD1","description":"ICD-CATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC0","description":"ICD-NLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX20","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69550","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular dev_ intraop_ det ret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1784","description":"Ocular dev_ intraop_ det ret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE0","description":"ICD-EBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD140","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE1","description":"ICD-MITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC1","description":"ICD-KEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB0","description":"ICD-DBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC31","description":"ICD-1LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5126","description":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21740","description":"Reconstruction of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0704T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA0","description":"ICD-GAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA1","description":"ICD-MIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach suction cath close sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4605","description":"Trach suction cath close sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB0","description":"ICD-AITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58578","description":"Laparo proc uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE1","description":"ICD-PKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB1","description":"ICD-GCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD0","description":"ICD-KFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE1","description":"ICD-IGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46942","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42650","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB1","description":"ICD-KHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA0","description":"ICD-FAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF1","description":"ICD-OJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA1","description":"ICD-FEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC0","description":"ICD-HIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of hip casts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29325","description":"Application of hip casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA21","description":"ICD-4HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB36","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6022","description":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES144","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0496","description":"Battery elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA0","description":"ICD-KESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59136","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43333","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"non - surgical sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7979","description":"non - surgical sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC1","description":"ICD-ADTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0010","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC0","description":"ICD-AEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC1","description":"ICD-EADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA0","description":"ICD-NHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB1","description":"ICD-OBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney function study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78725","description":"Kidney function study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc t-pa admin considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4077F","description":"Doc t-pa admin considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complement antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86160","description":"Complement antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65273","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of chest artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37616","description":"Ligation of chest artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axillary-axilry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35518","description":"Art byp grft axillary-axilry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE0","description":"ICD-KAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9395","description":"Injection_ fulvestrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36481","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA1","description":"ICD-CBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC1","description":"ICD-METC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA1","description":"ICD-BGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA1","description":"ICD-BGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic fine wire emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96003","description":"Dynamic fine wire emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0850","description":"Pwc gp 3 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limb muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95831","description":"Limb muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC1","description":"ICD-FFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28005","description":"Treat foot bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC0","description":"ICD-IADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD1","description":"ICD-PEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD225","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31577","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB0","description":"ICD-JHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride infected skin add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11001","description":"Debride infected skin add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF0","description":"ICD-HDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF0","description":"ICD-GFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC1","description":"ICD-JHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB1","description":"ICD-FEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Polysom 6/> yrs 4/> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95810","description":"Polysom 6/> yrs 4/> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Footrest complete assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0045","description":"Footrest complete assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic ftwear ladies oxf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3215","description":"Orthopedic ftwear ladies oxf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46601","description":"Diagnostic anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB1","description":"ICD-AEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pappa serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84163","description":"Pappa serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD1","description":"ICD-JBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cromolyn sodium noncomp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7631","description":"Cromolyn sodium noncomp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21615","description":"Removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA1","description":"ICD-MFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8686","description":"Implt nrostm pls gen sng non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrical stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97032","description":"Electrical stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indic for head ct valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9531","description":"Indic for head ct valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31512","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Erythro lactobionate /500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1364","description":"Erythro lactobionate /500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD1","description":"ICD-MFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8A","description":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX46","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoplasty congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43313","description":"Esophagoplasty congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","description":"HCPCS-Q4425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cranial cervical orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0112","description":"Cranial cervical orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2318","description":"Lens aniseikonic trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-myomectomy complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58546","description":"Laparo-myomectomy complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC156","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I&d absc intraoral soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7510","description":"I&d absc intraoral soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF1","description":"ICD-JDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368U","description":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF0","description":"ICD-JEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod solid food suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9434","description":"Mod solid food suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery expos/graft artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33987","description":"Artery expos/graft artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF1","description":"ICD-GFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF0","description":"ICD-OJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC0","description":"ICD-JFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA43","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0224","description":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ toripalimab-tpzi_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3263","description":"Injection_ toripalimab-tpzi_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ppps_ initial visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0438","description":"Ppps_ initial visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA1","description":"ICD-CAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE1","description":"ICD-JFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB1","description":"ICD-JCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA0","description":"ICD-IEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF1","description":"ICD-KGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ster wd ifx 30 d postop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8571","description":"Ster wd ifx 30 d postop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97163","description":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB0","description":"ICD-BCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA0","description":"ICD-AEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5220","description":"Hearing aid_ BICROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA0","description":"ICD-NGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE0","description":"ICD-GDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repr pul art unifocal w/cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33926","description":"Repr pul art unifocal w/cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC0","description":"ICD-LIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC SOLID TUMOR 30 PRTN TRGT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174U","description":"ONC SOLID TUMOR 30 PRTN TRGT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF1","description":"ICD-FCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC1","description":"ICD-KDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC0","description":"ICD-BBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel graft defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35870","description":"Repair vessel graft defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gr34 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2359","description":"Gr34 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legionella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86713","description":"Legionella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE1","description":"ICD-KEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF1","description":"ICD-NINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75956","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF1","description":"ICD-NJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49441","description":"Place duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD1","description":"ICD-MBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA1","description":"ICD-DEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perp bk ptb thermopls direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5520","description":"Perp bk ptb thermopls direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC1","description":"ICD-OIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1202","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA1","description":"ICD-KBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA1","description":"ICD-CGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36261","description":"Revision of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME1","description":"ICD-ADME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC0","description":"ICD-LGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA0","description":"ICD-PGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA0","description":"ICD-PHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD160","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB0","description":"ICD-KEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF1","description":"ICD-KEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13152","description":"Cmplx rpr e/n/e/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2206","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD1","description":"ICD-JECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit immunotherapy diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9338","description":"Hit immunotherapy diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF1","description":"ICD-KGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93298","description":"Ilr device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC1","description":"ICD-KIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF0","description":"ICD-KHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43101","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr >4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4408","description":"Ext wear ost skn barr >4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX14","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rear whl complete solid tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0069","description":"Rear whl complete solid tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43610","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE0","description":"ICD-PFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids mult qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82128","description":"Amino acids mult qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC0","description":"ICD-GAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB1","description":"ICD-KAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sensorineural acuity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92575","description":"Sensorineural acuity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0858","description":"Pwc gp3 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0080U","description":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical nutrition group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97804","description":"Medical nutrition group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24100","description":"Biopsy elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD1","description":"ICD-JALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB1","description":"ICD-CFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF1","description":"ICD-KBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA21","description":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4D","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF1","description":"ICD-OBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB1","description":"ICD-NDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelet antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86022","description":"Platelet antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA0","description":"ICD-CBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Barbiturates_ not elsewhere specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6043","description":"Barbiturates_ not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB1","description":"ICD-AAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA0","description":"ICD-OKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea 1 ses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435T","description":"Prgrmg eval npgs apnea 1 ses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC11","description":"ICD-1FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB0","description":"ICD-GIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB1","description":"ICD-EBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID1","description":"ICD-CHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70481","description":"Ct orbit/ear/fossa w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC0","description":"ICD-OLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA1","description":"ICD-IETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0833","description":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","description":"HCPCS-A5102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE0","description":"ICD-MHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24505","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC0","description":"ICD-OIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73525","description":"Contrast x-ray of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED1","description":"ICD-NJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9587","description":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC1","description":"ICD-KHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC0","description":"ICD-BIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE1","description":"ICD-PFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA1","description":"ICD-GALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460U","description":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA0","description":"ICD-NEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9367","description":"2high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD1","description":"ICD-NIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF1","description":"ICD-GFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair non-electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0171","description":"Commode chair non-electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB1","description":"ICD-FEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0285","description":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy with ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44401","description":"Colonoscopy with ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom shoes depth inlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3230","description":"Custom shoes depth inlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte culture primed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86822","description":"Lymphocyte culture primed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF0","description":"ICD-GEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC1","description":"ICD-CINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Full sole/heel wedge btween","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3420","description":"Full sole/heel wedge btween","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anal sp inf pmp w/reprg&fill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62369","description":"Anal sp inf pmp w/reprg&fill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE1","description":"ICD-ODPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC0","description":"ICD-GELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF1","description":"ICD-JDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD1","description":"ICD-GBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA0","description":"ICD-BEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE0","description":"ICD-NJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp carotid-vertebral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35642","description":"Art byp carotid-vertebral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harness chest/shlder saddle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6672","description":"Harness chest/shlder saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74327","description":"Postoperative biliary duct calculus removal_ percutaneous via t-tube tract_ basket_ or snare (eg_ burhenne technique)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE1","description":"ICD-LFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND0","description":"ICD-BHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cont pas motion exercise dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0935","description":"Cont pas motion exercise dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD1","description":"ICD-OFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB236","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC231","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ above knee_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6585","description":"Gradient pressure wrap with adjustable straps_ above knee_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn cervl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63285","description":"Bx/exc idrl imed lesn cervl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27396","description":"Transplant of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF1","description":"ICD-LASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6411","description":"Non-sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrocodeinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6045","description":"Dihydrocodeinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48540","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","description":"CPT-01820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap vent/abd hern proc comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49653","description":"Lap vent/abd hern proc comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove abdominal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38747","description":"Remove abdominal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic catheter for biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47510","description":"Introduction of percutaneous transhepatic catheter for biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC1","description":"ICD-JFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD0","description":"ICD-LEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0482U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","description":"CPT-0482U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0639T","description":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF0","description":"ICD-BHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE1","description":"ICD-OCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19085","description":"Bx breast 1st lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electric heat pad moist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0215","description":"Electric heat pad moist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF0","description":"ICD-GCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF0","description":"ICD-PCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specialized Medical Equipment and Supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0137","description":"Specialized Medical Equipment and Supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE0","description":"ICD-EHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96138","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC1","description":"ICD-BIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21251","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt dif pt comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9060","description":"Onc prac mgmt dif pt comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93592","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB1","description":"ICD-DEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB1","description":"ICD-GEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2561","description":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC1","description":"ICD-OGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA1","description":"ICD-EFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop kinetic balnce sensr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396T","description":"Intraop kinetic balnce sensr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE0","description":"ICD-KILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"History cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3492F","description":"History cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB0","description":"ICD-OCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF1","description":"ICD-NJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD0","description":"ICD-ADTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF1","description":"ICD-IAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51555","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE146","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF0","description":"ICD-EIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA1","description":"ICD-FHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No card tamp e/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9409","description":"No card tamp e/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE1","description":"ICD-BCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0919T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","description":"CPT-0919T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microscopic exam of urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81015","description":"Microscopic exam of urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5A","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF0","description":"ICD-MGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC0","description":"ICD-FDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99309","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF0","description":"ICD-DFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1195","description":"Wheelchair amputee heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD0","description":"ICD-OJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65280","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD1","description":"ICD-GHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27652","description":"Repair/graft achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE0","description":"ICD-GITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uvl sys panel 4 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0692","description":"Uvl sys panel 4 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC1","description":"ICD-CEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89050","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy removal of clots","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52001","description":"Cystoscopy removal of clots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD1","description":"ICD-CEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA21","description":"ICD-2LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calcium glycer & lact/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0620","description":"Calcium glycer & lact/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26480","description":"Transplant hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC1","description":"ICD-NHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB1","description":"ICD-CGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD1","description":"ICD-PBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE0","description":"ICD-CFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED1","description":"ICD-NEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko elastic w/joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1812","description":"Ko elastic w/joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extended culture of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89272","description":"Extended culture of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ikbkap gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81260","description":"Ikbkap gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF1","description":"ICD-JAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77078","description":"Ct bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermacyte Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4248","description":"Dermacyte Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj fem single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64447","description":"N block inj fem single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB1","description":"ICD-NFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate elbow w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24300","description":"Manipulate elbow w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA0","description":"ICD-NDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED1","description":"ICD-OCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB235","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD1","description":"ICD-PDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tint_ any color/solid/grad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2745","description":"Tint_ any color/solid/grad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE0","description":"ICD-OJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE0","description":"ICD-CHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0563U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","description":"CPT-0563U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB0","description":"ICD-BGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9204","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8H","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA0","description":"ICD-CHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB0","description":"ICD-OBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD155","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF0","description":"ICD-KARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8660","description":"Fun stat score ls < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0257U","description":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of proinsulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84206","description":"Assay of proinsulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8002","description":"Soft protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC0","description":"ICD-OEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF0","description":"ICD-KGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC0","description":"ICD-IHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF0","description":"ICD-EDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF1","description":"ICD-FGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC1","description":"ICD-ODDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28103","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dispense fee initial 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0333","description":"Dispense fee initial 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE1","description":"ICD-JDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20937","description":"Sp bone agrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Position wc cush wdth <22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2605","description":"Position wc cush wdth <22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC1","description":"ICD-IHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518T","description":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF1","description":"ICD-FFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3003","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB1","description":"ICD-FBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aorcel/aormesen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35531","description":"Art byp grft aorcel/aormesen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE1","description":"ICD-NLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4132F","description":"No syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy extraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57282","description":"Colpopexy extraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE0","description":"ICD-CBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA1","description":"ICD-BDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC1","description":"ICD-GHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA1","description":"ICD-BHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA0","description":"ICD-MDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC0","description":"ICD-KDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD1","description":"ICD-MEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90657","description":"Iiv3 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA1","description":"ICD-FBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB11","description":"ICD-2GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA0","description":"ICD-JBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA1","description":"ICD-BBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE0","description":"ICD-BBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB0","description":"ICD-NCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-eval post-op visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0171","description":"Re-eval post-op visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90651","description":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD1","description":"ICD-OCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD0","description":"ICD-MCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE0","description":"ICD-GIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64575","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay activated protein c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85307","description":"Assay activated protein c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"G-esoph reflx tst w/electrod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91035","description":"G-esoph reflx tst w/electrod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE150","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA10","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE0","description":"ICD-CFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB0","description":"ICD-EHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sesamoid bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28315","description":"Removal of sesamoid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC17","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brst prsths adhsv attchmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4280","description":"Brst prsths adhsv attchmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD1","description":"ICD-NDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiograph neck w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70549","description":"Mr angiograph neck w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD0","description":"ICD-EIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Angina present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1011F","description":"Angina present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27640","description":"Partial removal of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF0","description":"ICD-JABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE1","description":"ICD-NECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autogenous Av Fistula Received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8530","description":"Autogenous Av Fistula Received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90838","description":"Psytx pt&/fam w/e&m 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD1","description":"ICD-CGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB134","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD0","description":"ICD-JIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF0","description":"ICD-NJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE1","description":"ICD-NGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyzine pamoate 25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0177","description":"Hydroxyzine pamoate 25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD0","description":"ICD-BIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Receiving Palliative Care During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0034","description":"Patients Receiving Palliative Care During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2281","description":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB1","description":"ICD-OGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC1","description":"ICD-ICDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop follow-up visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99024","description":"Postop follow-up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove torus mandibularis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7473","description":"Remove torus mandibularis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE0","description":"ICD-CDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA1","description":"ICD-KBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB0","description":"ICD-OHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27333","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81296","description":"Msh2 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44381","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE1","description":"ICD-GAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-axilary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35516","description":"Art byp grft subclav-axilary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA0","description":"ICD-CGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag rig pnl stays pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0626","description":"Lo sag rig pnl stays pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE0","description":"ICD-GFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD0","description":"ICD-CEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF1","description":"ICD-PBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC1","description":"ICD-PAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF0","description":"ICD-OHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF1","description":"ICD-CDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED1","description":"ICD-OAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00537","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","description":"CPT-00537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA0","description":"ICD-JBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC0","description":"ICD-OEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9625","description":"Bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC0","description":"ICD-PJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB1","description":"ICD-BFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC0","description":"ICD-CGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB0","description":"ICD-GEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF0","description":"ICD-GDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF0","description":"ICD-MJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj chem pres ajcc iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8927","description":"Adj chem pres ajcc iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC0","description":"ICD-CIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC1","description":"ICD-CGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA1","description":"ICD-BAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB21","description":"ICD-2GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE0","description":"ICD-HBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB0","description":"ICD-GDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD1","description":"ICD-NIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE1","description":"ICD-OICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech therapy_ re-eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9152","description":"Speech therapy_ re-eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE1","description":"ICD-KIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Str markers spec anal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81266","description":"Str markers spec anal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","description":"HCPCS-Q5162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA0","description":"ICD-GGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC0","description":"ICD-FFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE0","description":"ICD-CBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Adaptations (<$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0140","description":"Home Adaptations (<$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF1","description":"ICD-GELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem odontogen cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7451","description":"Rem odontogen cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41110","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA1","description":"ICD-JFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND0","description":"ICD-KIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC1","description":"ICD-MCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair carpal bone shorten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25394","description":"Repair carpal bone shorten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA0","description":"ICD-FGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CaregraFT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4322","description":"CaregraFT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec childcare waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2027","description":"Spec childcare waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8999","description":"Orthodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB1","description":"ICD-OJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Single visn sphere 4.12-7.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2101","description":"Single visn sphere 4.12-7.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA1","description":"ICD-PFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext amb insulin delivery sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9274","description":"Ext amb insulin delivery sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB1","description":"ICD-GGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB0","description":"ICD-KALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD1","description":"ICD-OKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB0","description":"ICD-GDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD0","description":"ICD-FFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA1","description":"ICD-NFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA1","description":"ICD-ODDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA23","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo sprng wir drsflx calf bd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1900","description":"Afo sprng wir drsflx calf bd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44378","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE1","description":"ICD-BFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7295","description":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2b/10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0148","description":"Peg interferon alfa-2b/10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone scn b/4 txmnt/aftr dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3269F","description":"Bone scn b/4 txmnt/aftr dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair by enlargement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33610","description":"Repair by enlargement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC0","description":"ICD-BBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2 contents liquid lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8121","description":"O2 contents liquid lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9098","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0947","description":"Fracture frame attachmnts pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA0","description":"ICD-CGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC0","description":"ICD-MGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE1","description":"ICD-PFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD0","description":"ICD-OFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52344","description":"Cysto/uretero stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE1","description":"ICD-LCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB1","description":"ICD-LGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE0","description":"ICD-GDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND1","description":"ICD-JIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF1","description":"ICD-OBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No life asst 2x same/decr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9636","description":"No life asst 2x same/decr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB0","description":"ICD-NEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD0","description":"ICD-CIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmi calc_ pt no f/u plan elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8938","description":"Bmi calc_ pt no f/u plan elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE1","description":"ICD-NFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC0","description":"ICD-JHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd digitized pre-rec <=8min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2500","description":"Sgd digitized pre-rec <=8min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF1","description":"ICD-EECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3241","description":"Injection_ teprotumumab-trbw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27513","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC1","description":"ICD-GBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytomegalovirus dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87271","description":"Cytomegalovirus dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4043","description":"Cast sup lng leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB31","description":"ICD-3CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6280","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6280","description":"CDT-D6280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB0","description":"ICD-OAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bitewings - three films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0273","description":"Bitewings - three films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD1","description":"ICD-KAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE0","description":"ICD-MDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC0","description":"ICD-GGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF1","description":"ICD-NLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD0","description":"ICD-KDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE0","description":"ICD-EEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ foot_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6587","description":"Gradient pressure wrap with adjustable straps_ foot_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96131","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA1","description":"ICD-OJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinsert spinal fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22849","description":"Reinsert spinal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC31","description":"ICD-4LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Offset knee joint each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2390","description":"Offset knee joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pain doc pos and plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8730","description":"Pain doc pos and plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84133","description":"Assay of urine potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA1","description":"ICD-OLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA1","description":"ICD-BFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF1","description":"ICD-LCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35671","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB1","description":"ICD-FEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46261","description":"Remove in/ex hem grps & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA1","description":"ICD-OHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC31","description":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF0","description":"ICD-FAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF0","description":"ICD-JCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0501","description":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA1","description":"ICD-LGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD1","description":"ICD-KCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE0","description":"ICD-ODFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC11","description":"ICD-3DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA26","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","description":"HCPCS-M1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA0","description":"ICD-OGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0759","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","description":"HCPCS-J0759","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB31","description":"ICD-1KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE1","description":"ICD-HAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB1","description":"ICD-GBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert idrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63305","description":"Remove vert idrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Homecare train pt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5108","description":"Homecare train pt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD0","description":"ICD-GFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1027T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1027T","description":"CPT-1027T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX34","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35650","description":"Art byp axillary-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF0","description":"ICD-GCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","description":"HCPCS-J1307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB21","description":"ICD-4IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF1","description":"ICD-OGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47532","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93965","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB0","description":"ICD-LHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology breast mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81519","description":"Oncology breast mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0301","description":"HCPCS-C0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47361","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86632","description":"Chlamydia igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27217","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tmj condyle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7840","description":"Removal of tmj condyle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1006","description":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6935","description":"Below elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF0","description":"ICD-GHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA0","description":"ICD-BGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp multidisipln evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2000","description":"Comp multidisipln evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33417","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF1","description":"ICD-IFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trim nail(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0127","description":"Trim nail(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB0","description":"ICD-OAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD1","description":"ICD-KGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65436","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF0","description":"ICD-OKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD1","description":"ICD-MAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF0","description":"ICD-ACHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA1","description":"ICD-HGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF0","description":"ICD-IILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1428","description":"Injection_ eteplirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE1","description":"ICD-CDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft hip bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27067","description":"Remove/graft hip bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA0","description":"ICD-DISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90965","description":"Esrd home pt serv p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC0","description":"ICD-GEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA205","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD0","description":"ICD-GABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC1","description":"ICD-NAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB0","description":"ICD-IHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA0","description":"ICD-DBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB1","description":"ICD-NJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC11","description":"ICD-1KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9099","description":"Onc dx esophageal unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF1","description":"ICD-GFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB0","description":"ICD-KBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucose blood test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82962","description":"Glucose blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA20","description":"Medium Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0895T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ef calorie dense>/=1.5kcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4152","description":"Ef calorie dense>/=1.5kcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77620","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA1","description":"ICD-BCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66130","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF0","description":"ICD-GDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0116U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0638T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB0","description":"ICD-KCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB53","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC1","description":"ICD-JIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB1","description":"ICD-DBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE1","description":"ICD-KBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99204","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 1/2 node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31652","description":"Bronch ebus samplng 1/2 node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA0","description":"ICD-IHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE0","description":"ICD-FEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF0","description":"ICD-GDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE0","description":"ICD-JAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF0","description":"ICD-ICEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 4/5 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72083","description":"X-ray exam entire spi 4/5 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0911","description":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD1","description":"ICD-OHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA0","description":"ICD-OAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF1","description":"ICD-GHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC1","description":"ICD-NGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4386","description":"Non-pneum walk boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stoma absorptive cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5083","description":"Stoma absorptive cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC0","description":"ICD-NJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone sodium succinate_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2919","description":"Injection_ methylprednisolone sodium succinate_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD0","description":"ICD-OAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA11","description":"ICD-4GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal scaling & root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4341","description":"Periodontal scaling & root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74261","description":"Ct colonography dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF0","description":"ICD-NKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21146","description":"Lefort i-2 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA1","description":"ICD-IABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0407","description":"HCPCS-A0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51710","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove implant of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65920","description":"Remove implant of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD1","description":"ICD-BFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam/fabric leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5114","description":"Foam/fabric leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc membranes fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111T","description":"Rbc membranes fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23520","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD1","description":"ICD-CAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA1","description":"ICD-GFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64553","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC0","description":"ICD-FGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alginate dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6196","description":"Alginate dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB0","description":"ICD-FHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA1","description":"ICD-OFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF1","description":"ICD-OFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93586","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB1","description":"ICD-OIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50783","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC0","description":"ICD-JGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","description":"HCPCS-Q4341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA21","description":"ICD-1GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78832","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2188","description":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE1","description":"ICD-GAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA1","description":"ICD-KBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA0","description":"ICD-NCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Viral culture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0416","description":"Viral culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB1","description":"ICD-KBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIF1","description":"ICD-JIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF1","description":"ICD-ACHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA0","description":"ICD-FAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA1","description":"ICD-IDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60605","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF0","description":"ICD-DDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc advncd dis cmfrt not 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1153F","description":"Doc advncd dis cmfrt not 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-putty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9359","description":"Implnt_bon void filler-putty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF1","description":"ICD-JFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA31","description":"ICD-3FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE1","description":"ICD-JHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE1","description":"ICD-JDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paramed intrcept nonvol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0208","description":"Paramed intrcept nonvol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0801","description":"CDT-D0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy discectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7876","description":"Tmj arthroscopy discectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB15","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7563","description":"HCPCS-C7563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA0","description":"ICD-LFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj cutting of a muscle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7856","description":"Tmj cutting of a muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92998","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC0","description":"ICD-PGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gsc >15 & hd ct by ed md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9594","description":"Gsc >15 & hd ct by ed md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE1","description":"ICD-OKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nicardipine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2404","description":"Injection_ nicardipine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE0","description":"ICD-LDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC1","description":"ICD-KHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC1","description":"ICD-GINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB0","description":"ICD-KGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentur repr broken compl bas","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5510","description":"Dentur repr broken compl bas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ piperacillin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0081","description":"Injection_ piperacillin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE1","description":"ICD-NGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC0","description":"ICD-KFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95145","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4368","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","description":"HCPCS-Q4368","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA1","description":"ICD-OKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel thomas extend to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3470","description":"Shoe heel thomas extend to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11450","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF1","description":"ICD-NHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB0","description":"ICD-FCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47000","description":"Needle biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Standard wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0001","description":"Standard wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB1","description":"ICD-KIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF1","description":"ICD-OBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72157","description":"MRI chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2137","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF1","description":"ICD-ICMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ gold-198","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1716","description":"Brachytx_ non-str_ gold-198","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29886","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA0","description":"ICD-HBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect radius/ulnar tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25170","description":"Resect radius/ulnar tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0744T","description":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB0","description":"ICD-CIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cefoxitin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0694","description":"Cefoxitin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB1","description":"ICD-CFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC14","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND0","description":"ICD-NIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA0","description":"ICD-JHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF1","description":"ICD-BDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried prkns complic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4324F","description":"Pt queried prkns complic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC0","description":"ICD-KDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE0","description":"ICD-BDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular device implantation_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0725T","description":"Vestibular device implantation_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak univ multiplex sys frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5616","description":"Ak univ multiplex sys frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB0","description":"ICD-LCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA21","description":"ICD-2AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF0","description":"ICD-OCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55711","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","description":"CPT-55711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD0","description":"ICD-MGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9632","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00944","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","description":"CPT-00944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF1","description":"ICD-OJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose/reagent strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4253","description":"Blood glucose/reagent strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ bal dil_ non-vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1726","description":"Cath_ bal dil_ non-vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA1","description":"ICD-IGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA0","description":"ICD-IHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plastic surgery neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15819","description":"Plastic surgery neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","description":"HCPCS-Q4370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA1","description":"ICD-PAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6694","description":"Elbow socket ins use w/lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF1","description":"ICD-NBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB0","description":"ICD-FGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF0","description":"ICD-KAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (hepzato)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9248","description":"Injection_ melphalan (hepzato)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC0","description":"ICD-AGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ synthetic_ resorbable_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1849","description":"Skin substitute_ synthetic_ resorbable_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF0","description":"ICD-NJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF1","description":"ICD-CHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","description":"HCPCS-Q4415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lamina/facets lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63012","description":"Remove lamina/facets lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE1","description":"ICD-JDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34714","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC0","description":"ICD-GBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED0","description":"ICD-FCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metatarsal joint implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8641","description":"Metatarsal joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures immediat mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5140","description":"Dentures immediat mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC1","description":"ICD-NCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF1","description":"ICD-GGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9668","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA0","description":"ICD-MHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB0","description":"ICD-OAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0836","description":"Pwc gp2 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27591","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB1","description":"ICD-BEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","description":"HCPCS-A2039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE0","description":"ICD-GHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9347","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound warming device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0231","description":"Wound warming device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB1","description":"ICD-NDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB0","description":"ICD-ECCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cine/video x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76120","description":"Cine/video x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID0","description":"ICD-EBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antisperm antibodies test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3655","description":"Antisperm antibodies test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4027","description":"Cast sup hip spica ped plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52260","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of hemoglobin heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83065","description":"Assay of hemoglobin heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92229","description":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA0","description":"ICD-CDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair hvy duty detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1290","description":"Wheelchair hvy duty detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE0","description":"ICD-CFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fmr1 gene detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81243","description":"Fmr1 gene detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA0","description":"ICD-GFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26205","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD1","description":"ICD-JHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA1","description":"ICD-JDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fuse&remov bel c2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22551","description":"Neck spine fuse&remov bel c2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA1","description":"ICD-NJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87564","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","description":"CPT-87564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach care kit for new trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4625","description":"Trach care kit for new trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9797","description":"Patient is not on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery chrgr six volt otto","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7362","description":"Battery chrgr six volt otto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise abdomen-venous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49426","description":"Revise abdomen-venous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA0","description":"ICD-GETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC11","description":"ICD-3BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of metanephrines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83835","description":"Assay of metanephrines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2165","description":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fungus nes antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86671","description":"Fungus nes antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31595","description":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB1","description":"ICD-GADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cciiv3 vac im cult prsv free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90661","description":"Cciiv3 vac im cult prsv free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB1","description":"ICD-DHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD0","description":"ICD-KHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81338","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11603","description":"Exc tr-ext mal+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF1","description":"ICD-OGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 3 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0492","description":"Tlso 3 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF1","description":"ICD-NCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE1","description":"ICD-KIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-35602","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","description":"CPT-35602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB0","description":"ICD-NBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v <1.2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3082F","description":"Kt/v <1.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bebtelovimab_ 175 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0222","description":"Injection_ bebtelovimab_ 175 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61314","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6118","description":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC0","description":"ICD-JINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB1","description":"ICD-JHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing rbc antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86905","description":"Blood typing rbc antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulp vitality test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0460","description":"Pulp vitality test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF0","description":"ICD-KAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD0","description":"ICD-OHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE0","description":"ICD-GBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27090","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA31","description":"ICD-2FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD1","description":"ICD-CGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1C","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3B","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE1","description":"ICD-FEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88261","description":"Chromosome analysis 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA1","description":"ICD-GFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA1","description":"ICD-NCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1102","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE220","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF0","description":"ICD-NDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction maxilla total","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7946","description":"Reconstruction maxilla total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electromagntic tx for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0329","description":"Electromagntic tx for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35236","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pegademase bovine_ 25 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2504","description":"Pegademase bovine_ 25 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA0","description":"ICD-GACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC0","description":"ICD-KCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB245","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD1","description":"ICD-IAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA1","description":"ICD-PBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC0","description":"ICD-OAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0479T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD1","description":"ICD-IDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interscapular-thor switch ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6970","description":"Interscapular-thor switch ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF0","description":"ICD-KFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC1","description":"ICD-KAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA1","description":"ICD-FDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2211","description":"Lens sphcy bifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Modify speech aid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5960","description":"Modify speech aid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA0","description":"ICD-FDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE1","description":"ICD-ECTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE1","description":"ICD-GBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL20","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA0","description":"ICD-MDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE226","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE1","description":"ICD-KFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elb disart prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6450","description":"Elb disart prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC0","description":"ICD-LGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol ipratrop non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7620","description":"Albuterol ipratrop non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/ch access det adj armrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0973","description":"W/ch access det adj armrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25035","description":"Treat forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31529","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES260","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42226","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD1","description":"ICD-JCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB0","description":"ICD-NLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC1","description":"ICD-KILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB1","description":"ICD-MJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE0","description":"ICD-OKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA0","description":"ICD-GDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA1","description":"ICD-KCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC0","description":"ICD-KGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF0","description":"ICD-BDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61616","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC1","description":"ICD-LBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME0","description":"ICD-MEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC0","description":"ICD-LHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF1","description":"ICD-PKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC1","description":"ICD-ECAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26356","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE1","description":"ICD-FGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF1","description":"ICD-GFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA0","description":"ICD-JELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA03","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2124","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC0","description":"ICD-DHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6517","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","description":"HCPCS-A6517","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA0","description":"ICD-OELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA1","description":"ICD-BGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF1","description":"ICD-JANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65900","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breath test analysis c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78268","description":"Breath test analysis c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA31","description":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pap prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8850","description":"No pap prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cog&behav imprmnt scrng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3755F","description":"Cog&behav imprmnt scrng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME1","description":"ICD-MLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB0","description":"ICD-GILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB0","description":"ICD-FHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB0","description":"ICD-JBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF1","description":"ICD-EACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0203","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0203","description":"CDT-D0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii reltd antgn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85244","description":"Clot factor viii reltd antgn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA0","description":"ICD-GAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hm preeclamp per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9213","description":"Hm preeclamp per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Part hand little/ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6010","description":"Part hand little/ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF1","description":"ICD-OKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA0","description":"ICD-FFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86363","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4133F","description":"Antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rvw meds by rx/dr in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1160F","description":"Rvw meds by rx/dr in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61684","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trnslum dil eye canal w/stnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66175","description":"Trnslum dil eye canal w/stnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB1","description":"ICD-GIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calculus analysis qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82355","description":"Calculus analysis qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81183","description":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE1","description":"ICD-FFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL01","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD1","description":"ICD-BIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB1","description":"ICD-KCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC1","description":"ICD-PASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vendaje_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4252","description":"Vendaje_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB1","description":"ICD-OAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67966","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA1","description":"ICD-IFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE0","description":"ICD-FFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24582","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466U","description":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32998","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB0","description":"ICD-KEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE1","description":"ICD-EGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF0","description":"ICD-CASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73201","description":"Ct upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC0","description":"ICD-JEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC126","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD1","description":"ICD-HAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB1","description":"ICD-KCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD0","description":"ICD-IHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD0","description":"ICD-OJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC1","description":"ICD-GFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66635","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52051","description":"Anesth chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1048","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD0","description":"ICD-DBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB0","description":"ICD-GCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC0","description":"ICD-AATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7613","description":"Albuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB1","description":"ICD-BCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE110","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC0","description":"ICD-KDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD0","description":"ICD-OIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC0","description":"ICD-CAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE0","description":"ICD-OHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA0","description":"ICD-CFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF0","description":"ICD-NBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22207","description":"Incis spine 3 column lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","description":"HCPCS-J2601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE0","description":"ICD-GACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB1","description":"ICD-PKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE0","description":"ICD-IILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted px small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44799","description":"Unlisted px small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnt pain noted pain prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1125F","description":"Amnt pain noted pain prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME0","description":"ICD-AHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE1","description":"ICD-HGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bckdhb gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81205","description":"Bckdhb gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fitting of diaphragm/cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57170","description":"Fitting of diaphragm/cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD0","description":"ICD-JAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0958T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","description":"CPT-0958T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion = 3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6601","description":"Porc/ceram inlay >= 3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1040T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1040T","description":"CPT-1040T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27822","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2781","description":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1392","description":"Portable oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Io map of sent lymph node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38900","description":"Io map of sent lymph node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5%dextrose/0.45%saline1000ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5013","description":"5%dextrose/0.45%saline1000ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA1","description":"ICD-GASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF1","description":"ICD-GCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.12-7.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2301","description":"Lens sphere trifocal 4.12-7.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","description":"HCPCS-G0541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE0","description":"ICD-BIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0874T","description":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD1","description":"ICD-OEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sio rig pnl pelv/sac pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0623","description":"Sio rig pnl pelv/sac pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1016","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2001","description":"CDT-D2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE0","description":"ICD-NHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Guide wire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1769","description":"Guide wire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD0","description":"ICD-JBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF0","description":"ICD-NAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX16","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA0","description":"ICD-CDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB124","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID1","description":"ICD-NIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0650","description":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE0","description":"ICD-OIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA1","description":"ICD-KDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB1","description":"ICD-PJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE0","description":"ICD-MCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD1","description":"ICD-ABTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8698","description":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD1","description":"ICD-OCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51525","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73701","description":"Ct lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81187","description":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL54","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27323","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF0","description":"ICD-FGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC0","description":"ICD-HCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received bone marrow transplant any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1157","description":"Patient received bone marrow transplant any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA1","description":"ICD-OEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA1","description":"ICD-NLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA0","description":"ICD-ECCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA1","description":"ICD-PERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0201","description":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB34","description":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE0","description":"ICD-KBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal cord puncture prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59012","description":"Fetal cord puncture prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd tube/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43241","description":"Egd tube/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0628U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","description":"CPT-0628U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m exametazime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9521","description":"Tc99m exametazime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF1","description":"ICD-CCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB0","description":"ICD-HAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2169","description":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85291","description":"Clot factor xiii fibrin scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko elas w/ condyle pads & jo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1820","description":"Ko elas w/ condyle pads & jo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco nonsmoker nor 2ndhnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1033F","description":"Tobacco nonsmoker nor 2ndhnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj open reduct-dislocation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7810","description":"Tmj open reduct-dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject hrt congntl art/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93564","description":"Inject hrt congntl art/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC0","description":"ICD-DASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61682","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB0","description":"ICD-EHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB31","description":"ICD-1EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF0","description":"ICD-FABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA0","description":"ICD-MKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA0","description":"ICD-PFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD0","description":"ICD-NGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF1","description":"ICD-PDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA1","description":"ICD-CCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bacterium antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86609","description":"Bacterium antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9967","description":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF1","description":"ICD-KFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD0","description":"ICD-NHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA1","description":"ICD-NJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC0","description":"ICD-NENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraabdominal pressure test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51797","description":"Intraabdominal pressure test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Afo doub solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1990","description":"Afo doub solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF0","description":"ICD-CEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy face plate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4361","description":"Ostomy face plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC0","description":"ICD-BEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF0","description":"ICD-IHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA1","description":"ICD-GGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC0","description":"ICD-MHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair pulmonary atresia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33920","description":"Repair pulmonary atresia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF1","description":"ICD-JHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE1","description":"ICD-MLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneum compressor segmental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0651","description":"Pneum compressor segmental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE212","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair lead pace-defib dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33220","description":"Repair lead pace-defib dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy vent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4366","description":"Ostomy vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD0","description":"ICD-CCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB0","description":"ICD-OIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC0","description":"ICD-PFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD250","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx dprsd malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21360","description":"Opn tx dprsd malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7650","description":"Isoetharine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33468","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF1","description":"ICD-FCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1325","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD1","description":"ICD-ADBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2320","description":"Lens trifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD0","description":"ICD-KDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject epidural patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62273","description":"Inject epidural patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD0","description":"ICD-EHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80420","description":"Dexamethasone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9420","description":"Hospital call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF1","description":"ICD-JDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC0","description":"ICD-GIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC0","description":"ICD-LEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD1","description":"ICD-EHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal fluid drainage w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59074","description":"Fetal fluid drainage w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB07","description":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 2-3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72040","description":"X-ray exam neck spine 2-3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB1","description":"ICD-OFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23670","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB0","description":"ICD-PDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blooc clot factor v test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85220","description":"Blooc clot factor v test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00550","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","description":"CPT-00550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE0","description":"ICD-JGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval opioid use instr/pt int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9584","description":"Eval opioid use instr/pt int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB1","description":"ICD-OIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cipaglucosidase alfa-atga_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1203","description":"Injection_ cipaglucosidase alfa-atga_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE1","description":"ICD-MKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46750","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0844T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF1","description":"ICD-NAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB1","description":"ICD-GEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37279","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","description":"CPT-37279","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF0","description":"ICD-MAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6722","description":"Crown resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21620","description":"Partial removal of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1554","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0301","description":"HCPCS-A0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC0","description":"ICD-BDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA0","description":"ICD-NKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB0","description":"ICD-MLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC1","description":"ICD-KIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD0","description":"ICD-NGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive hormone patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7304","description":"Contraceptive hormone patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF0","description":"ICD-OGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD1","description":"ICD-NIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE0","description":"ICD-MHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC0","description":"ICD-OFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63301","description":"Remove vert xdrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD0","description":"ICD-EFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF1","description":"ICD-NDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB0","description":"ICD-OGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Misoprostol_ oral_ 200 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0191","description":"Misoprostol_ oral_ 200 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specimen not intraop image","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8873","description":"Specimen not intraop image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryoablate prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55873","description":"Cryoablate prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE1","description":"ICD-AECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ propofol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2704","description":"Inj_ propofol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28153","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB0","description":"ICD-ABHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE1","description":"ICD-GGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF1","description":"ICD-MJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE0","description":"ICD-GEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE1","description":"ICD-CDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rho d immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2790","description":"Rho d immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2072","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28510","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary retinal disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81434","description":"Hereditary retinal disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB0","description":"ICD-JFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove jaw joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21060","description":"Remove jaw joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Theragenesis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2008","description":"Theragenesis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","description":"HCPCS-L6036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE0","description":"ICD-KIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Integrated filter & holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7507","description":"Integrated filter & holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD1","description":"ICD-BDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0566U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","description":"CPT-0566U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sbsq nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99462","description":"Sbsq nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF0","description":"ICD-FIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX12","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE0","description":"ICD-MIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC1","description":"ICD-OJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst base mtl 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6612","description":"Onlay cst base mtl 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd w barrier/filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4416","description":"Ost pch clsd w barrier/filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who utilize hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9768","description":"Patients who utilize hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniowrap2_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4221","description":"Amniowrap2_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC1","description":"ICD-LBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC0","description":"ICD-AACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB0","description":"ICD-OLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA1","description":"ICD-FFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE1","description":"ICD-CDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC0","description":"ICD-OEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE0","description":"ICD-GASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF0","description":"ICD-OBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF0","description":"ICD-OENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o 3+ post-opnausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4557F","description":"Pt w/o 3+ post-opnausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj codeine phosphate /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0745","description":"Inj codeine phosphate /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex hd hosp bed > 600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0302","description":"Ex hd hosp bed > 600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD1","description":"ICD-NJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Color cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0514","description":"Color cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF1","description":"ICD-PDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX02","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert uteri tandem/ovoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57155","description":"Insert uteri tandem/ovoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC0","description":"ICD-NFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no rh-immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8810","description":"Doc reas no rh-immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC1","description":"ICD-OCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB1","description":"ICD-ICUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441U","description":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE1","description":"ICD-NKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD0","description":"ICD-LCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2132","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91200","description":"Liver elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF0","description":"ICD-NEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addl neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22552","description":"Addl neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC0","description":"ICD-NLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB144","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93226","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90645","description":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC0","description":"ICD-NEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD1","description":"ICD-GDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25805","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD0","description":"ICD-JBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull (press relief)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61343","description":"Incise skull (press relief)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX42","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9484","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA1","description":"ICD-JEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD1","description":"ICD-JACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC0","description":"ICD-PCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinusitis comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9464","description":"Sinusitis comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9483","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD0","description":"ICD-FCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB0","description":"ICD-ABUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD0","description":"ICD-OCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD1","description":"ICD-OIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID0","description":"ICD-MEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD0","description":"ICD-MGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA1","description":"ICD-MDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF1","description":"ICD-GGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77285","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB0","description":"ICD-AAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC0","description":"ICD-CIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9438","description":"P2y inhib presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB1","description":"ICD-NFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD0","description":"ICD-OGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drill skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61108","description":"Drill skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2094","description":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB1","description":"ICD-FGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC0","description":"ICD-OFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE1","description":"ICD-MFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC1","description":"ICD-GDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE1","description":"ICD-FICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE110","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68500","description":"Removal of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4352","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","description":"HCPCS-Q4352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9999","description":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93040","description":"Rhythm ecg with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl trach puncture dilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8514","description":"Repl trach puncture dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA1","description":"ICD-BAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asthma impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2015F","description":"Asthma impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD1","description":"ICD-JAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF0","description":"ICD-GCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta dev setup&educaj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0604T","description":"Rem oct rta dev setup&educaj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA0","description":"ICD-EDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF1","description":"ICD-IHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC0","description":"ICD-GAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay cyclosporine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80158","description":"Drug assay cyclosporine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA0","description":"ICD-GGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14041","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient occurred any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9720","description":"Hospice services for patient occurred any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6566","description":"Gradient compression garment_ neck/head_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35211","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF0","description":"ICD-NBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA0","description":"ICD-KGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove interim implant component","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6198","description":"Remove interim implant component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4021","description":"Orthopedic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE1","description":"ICD-KAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Testicular imaging w/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78761","description":"Testicular imaging w/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periton dialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507F","description":"Periton dialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA0","description":"ICD-FCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB0","description":"ICD-BCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53425","description":"Reconstruct urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c medial thigh support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0957","description":"W/c medial thigh support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1465","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","description":"HCPCS-M1465","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD0","description":"ICD-GEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68110","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA0","description":"ICD-OAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51550","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cerv cancer screen docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3015F","description":"Cerv cancer screen docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB0","description":"ICD-OHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental panoramic film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0330","description":"Dental panoramic film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE0","description":"ICD-AGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD1","description":"ICD-BCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE0","description":"ICD-OBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA0","description":"ICD-AFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF0","description":"ICD-BEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF0","description":"ICD-BIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD1","description":"ICD-BFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0930","description":"Fracture frame free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC0","description":"ICD-NDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72146","description":"MRI chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE0","description":"ICD-NDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC1","description":"ICD-AFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC54","description":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43336","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4A","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB1","description":"ICD-DASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA1","description":"ICD-OAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA0","description":"ICD-BAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD0","description":"ICD-PARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE0","description":"ICD-CECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gr27 non-sealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2372","description":"Gr27 non-sealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC0","description":"ICD-MLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383U","description":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc of neg or man pos tb scn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9359","description":"Doc of neg or man pos tb scn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF0","description":"ICD-NBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC1","description":"ICD-FHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF0","description":"ICD-KHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene minor bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81207","description":"Bcr/abl1 gene minor bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot and ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28262","description":"Revision of foot and ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01610","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","description":"CPT-01610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE1","description":"ICD-NCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelet pheres leukoreduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9035","description":"Platelet pheres leukoreduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SC GNOTYP ERMAP EXONS 4 12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0199U","description":"SC GNOTYP ERMAP EXONS 4 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0302","description":"CDT-D0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4023","description":"Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA1","description":"ICD-JDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA1","description":"ICD-OHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","description":"HCPCS-J7356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD1","description":"ICD-KFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of somatostatin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84307","description":"Assay of somatostatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44363","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA0","description":"ICD-ICMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA1","description":"ICD-CADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0595","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD0","description":"ICD-OKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF0","description":"ICD-OFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75803","description":"Lymph vessel x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc back tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21932","description":"Exc back tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF0","description":"ICD-EELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice refer visit nonmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0255","description":"Hospice refer visit nonmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA0","description":"ICD-FIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21245","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC1","description":"ICD-GELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24586","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55801","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE1","description":"ICD-CIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB0","description":"ICD-EAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD0","description":"ICD-OAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD0","description":"ICD-BDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE1","description":"ICD-CBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand restorat thumb/1 finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6900","description":"Hand restorat thumb/1 finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cpm device_ other than knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0936","description":"Cpm device_ other than knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Local anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9215","description":"Local anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tpa initi w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8600","description":"Tpa initi w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE1","description":"ICD-JBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF1","description":"ICD-GAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC1","description":"ICD-IECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE1","description":"ICD-BGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC0","description":"ICD-NBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD0","description":"ICD-FIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD1","description":"ICD-CIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cricotracheal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31592","description":"Cricotracheal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC145","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD1","description":"ICD-BCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of bradykinin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82286","description":"Assay of bradykinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC0","description":"ICD-JGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE0","description":"ICD-OJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF1","description":"ICD-GFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA0","description":"ICD-BDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE0","description":"ICD-HHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1702","description":"HCPCS-B1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF1","description":"ICD-GHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1085","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81299","description":"Msh6 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB11","description":"ICD-4JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA0","description":"ICD-EDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF1","description":"ICD-DCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE1","description":"ICD-GFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB0","description":"ICD-BBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF1","description":"ICD-PKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1251","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA0","description":"ICD-IIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asp presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9435","description":"Asp presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33969","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF1","description":"ICD-BCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE1","description":"ICD-CCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD1","description":"ICD-CCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB0","description":"ICD-CEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB1","description":"ICD-KIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF0","description":"ICD-PDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrode stimulation brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95961","description":"Electrode stimulation brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA0","description":"ICD-KBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symes type medial opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5636","description":"Symes type medial opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC0","description":"ICD-OCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE1","description":"ICD-MGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28220","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212U","description":"RARE DS GEN DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cva device obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75901","description":"Remove cva device obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96373","description":"Ther/proph/diag inj ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1359","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA1","description":"ICD-GHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB0","description":"ICD-DGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84578","description":"Test urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4B","description":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uvl pnl 2 sq ft or less","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0691","description":"Uvl pnl 2 sq ft or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1527","description":"Space maintainer_ removable bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC0","description":"ICD-OARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB0","description":"ICD-ICMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB0","description":"ICD-GFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9755","description":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD0","description":"ICD-FDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","description":"HCPCS-J1164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA0","description":"ICD-KBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE1","description":"ICD-NJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia sympts assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1181F","description":"Neuropsychia sympts assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB0","description":"ICD-OKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD0","description":"ICD-BHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC0","description":"ICD-FADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES115","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED1","description":"ICD-JAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Burr hole for puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61120","description":"Burr hole for puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0837","description":"Pwc gp 2 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA1","description":"ICD-BEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2792","description":"Crown full cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA1","description":"ICD-FBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Galsulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1458","description":"Galsulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE1","description":"ICD-FEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD1","description":"ICD-DCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58410","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9781","description":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD0","description":"ICD-NBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply rem fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20660","description":"Apply rem fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified diagnostic proce","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0999","description":"Unspecified diagnostic proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA1","description":"ICD-JEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8932","description":"Mra_ w/o dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60521","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0546","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","description":"HCPCS-G0546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD1","description":"ICD-KAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA1","description":"ICD-GDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF0","description":"ICD-LBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE1","description":"ICD-DDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE0","description":"ICD-JEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc 2x re-assess filt remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9543","description":"Doc 2x re-assess filt remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Inherited Thrombocytopenia Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0276U","description":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Inherited Thrombocytopenia Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB1","description":"ICD-BALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB1","description":"ICD-AHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA1","description":"ICD-HDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I&d p-spine c/t/cerv-thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22010","description":"I&d p-spine c/t/cerv-thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid frame pre subclav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0470","description":"Tlso rigid frame pre subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm system_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5281","description":"Ald fm/dm system_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC1","description":"ICD-LDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB1","description":"ICD-BCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romosozumab-aqqg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3111","description":"Injection_ romosozumab-aqqg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3161","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg wrst/elb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6380","description":"Postop dsg cast chg wrst/elb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME1","description":"ICD-FIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs lwr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29581","description":"Apply multlay comprs lwr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD1","description":"ICD-NFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgicl dress hold non-reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4461","description":"Surgicl dress hold non-reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Declot vascular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36593","description":"Declot vascular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA1","description":"ICD-NDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF1","description":"ICD-MDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24545","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide sol_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9530","description":"I131 iodide sol_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC1","description":"ICD-KBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE0","description":"ICD-FIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB21","description":"ICD-2EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA1","description":"ICD-OAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA0","description":"ICD-KGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25240","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC0","description":"ICD-CHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB0","description":"ICD-OFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.5 cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11400","description":"Exc tr-ext b9+marg 0.5 cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB1","description":"ICD-EIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE1","description":"ICD-CIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF1","description":"ICD-CGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8721","description":"Pt_ pn_ hist grade doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8G","description":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF0","description":"ICD-LEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystoenterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47570","description":"Laparo cholecystoenterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0591U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","description":"CPT-0591U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant cochlear device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69930","description":"Implant cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0683U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683U","description":"CPT-0683U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test indirect qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86885","description":"Coombs test indirect qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD1","description":"ICD-NIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thiotepa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9340","description":"Thiotepa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE1","description":"ICD-NCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF0","description":"ICD-OETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC1","description":"ICD-CBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA0","description":"ICD-GBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of head injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62010","description":"Treatment of head injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98002","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","description":"CPT-98002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD1","description":"ICD-PKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bumetanide 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0171","description":"Bumetanide 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE1","description":"ICD-NJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB0","description":"ICD-GACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84446","description":"Assay of vitamin e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0567","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9161","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA1","description":"ICD-EAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0953T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","description":"CPT-0953T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w/ supinat/pronator c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3202","description":"Oxford w/ supinat/pronator c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA0","description":"ICD-ODBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9680","description":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC0","description":"ICD-EGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29000","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA0","description":"ICD-OFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB1","description":"ICD-GATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1197","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81191","description":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF0","description":"ICD-OJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF1","description":"ICD-OHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA0","description":"ICD-JAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD0","description":"ICD-KDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7560","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC1","description":"ICD-CCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF1","description":"ICD-OFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD1","description":"ICD-JHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5140","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","description":"HCPCS-Q5140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC0","description":"ICD-IBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB1","description":"ICD-BIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE1","description":"ICD-ODEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF1","description":"ICD-BIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screen c/v thin layer by md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0124","description":"Screen c/v thin layer by md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE1","description":"ICD-KBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005F","description":"Osteoarthritis composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA0","description":"ICD-BGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF1","description":"ICD-EICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facial moulage sectional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5911","description":"Facial moulage sectional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7501","description":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc lymphatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38589","description":"Laparoscope proc lymphatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6512","description":"Compres burn garment_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB215","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE1","description":"ICD-KILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","description":"CPT-01470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft t/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15150","description":"Cult skin grft t/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE1","description":"ICD-EIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC0","description":"ICD-GEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE0","description":"ICD-JCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD0","description":"ICD-GDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC0","description":"ICD-KIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole cor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3320","description":"Shoe lift elev heel/sole cor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close mult vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33675","description":"Close mult vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0577U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","description":"CPT-0577U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF1","description":"ICD-CDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB0","description":"ICD-KAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subs visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526F","description":"Subs visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc chl syp documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9228","description":"Gc chl syp documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF0","description":"ICD-NAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD0","description":"ICD-CIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE1","description":"ICD-NJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC151","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC1","description":"ICD-KCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED0","description":"ICD-OHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87808","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26460","description":"Incise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43499","description":"Esophagus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5135","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","description":"HCPCS-Q5135","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9138","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF1","description":"ICD-NIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD0","description":"ICD-CIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5147","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","description":"HCPCS-Q5147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1093","description":"Wheelchair wide w/ foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE0","description":"ICD-IBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA1","description":"ICD-BBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF1","description":"ICD-FFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA1","description":"ICD-OBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF1","description":"ICD-FHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC0","description":"ICD-IFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/labral repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29916","description":"Hip arthro w/labral repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transect artery sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61611","description":"Transect artery sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","description":"HCPCS-Q4436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB1","description":"ICD-GBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27000","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70015","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC1","description":"ICD-FBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl devital tis addl 20cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97598","description":"Rmvl devital tis addl 20cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA1","description":"ICD-GEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49594","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9722","description":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD0","description":"ICD-HDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB1","description":"ICD-MFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lowr extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5999","description":"Lowr extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF1","description":"ICD-CCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL21","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD1","description":"ICD-JHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA1","description":"ICD-GIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA0","description":"ICD-BGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC1","description":"ICD-CCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF0","description":"ICD-BHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1442","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","description":"HCPCS-M1442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE0","description":"ICD-GIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise bladder & ureter(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51565","description":"Revise bladder & ureter(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE1","description":"ICD-AEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift bathroom or toi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0625","description":"Patient lift bathroom or toi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB31","description":"ICD-2JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE0","description":"ICD-IDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycoplasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87109","description":"Mycoplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil ed waiver per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2013","description":"Habil ed waiver per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME0","description":"ICD-EBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm phone r-strip device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93293","description":"Pm phone r-strip device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF1","description":"ICD-OAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF1","description":"ICD-FIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB1","description":"ICD-FGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC1","description":"ICD-OBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmv antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86645","description":"Cmv antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB1","description":"ICD-MKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit intermit chemo diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9331","description":"Hit intermit chemo diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC1","description":"ICD-GAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22548","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA1","description":"ICD-KDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD0","description":"ICD-FHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50430","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC1","description":"ICD-EGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup band/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2020","description":"Kafo dbl solid stirrup band/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","description":"HCPCS-Q4361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF1","description":"ICD-EDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB0","description":"ICD-KGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB0","description":"ICD-OCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD1","description":"ICD-CHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj olanzapine 2.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0166","description":"Inj olanzapine 2.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15778","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA0","description":"ICD-NHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS DELTA ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87380","description":"IAAD IA HEPATITIS DELTA ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA1","description":"ICD-EGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC0","description":"ICD-OJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD0","description":"ICD-ECCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth amputation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93251","description":"Anesth amputation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA1","description":"ICD-KBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1609","description":"HCPCS-C1609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63081","description":"Remove vert body dcmprn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4065F","description":"Antipsychotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25905","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC1","description":"ICD-BEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt mult chr msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9669","description":"Intend rpt mult chr msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA1","description":"ICD-CGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC0","description":"ICD-GDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB0","description":"ICD-ABBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB0","description":"ICD-OBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD1","description":"ICD-MJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15574","description":"Pedcle fh/ch/ch/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","description":"CPT-00860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD1","description":"ICD-GGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q2057","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","description":"HCPCS-Q2057","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78262","description":"Gastroesophageal reflux exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE1","description":"ICD-CAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct injured chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32820","description":"Reconstruct injured chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98985","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","description":"CPT-98985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD0","description":"ICD-GDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28635","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5A","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD1","description":"ICD-OATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88020","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA0","description":"ICD-GEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glofitamab-gxbm_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9286","description":"Injection_ glofitamab-gxbm_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE0","description":"ICD-MBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53270","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64596","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF1","description":"ICD-JGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not have the retina attached after 6 months following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9377","description":"Patient did not have the retina attached after 6 months following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE0","description":"ICD-ACLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0435","description":"Oral hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipid panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80061","description":"Lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC0","description":"ICD-DBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC0","description":"ICD-CGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD0","description":"ICD-NBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3807","description":"Whfo w/o joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD0","description":"ICD-NJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE0","description":"ICD-OEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26860","description":"Fusion of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF1","description":"ICD-JBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054A","description":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD1","description":"ICD-PFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF0","description":"ICD-FANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB1","description":"ICD-MBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped size pull-on sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4531","description":"Ped size pull-on sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21260","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC1","description":"ICD-ECUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","description":"CPT-55710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sagit rigid panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0635","description":"Lso sagit rigid panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC1","description":"ICD-LHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF1","description":"ICD-KIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95706","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","description":"CPT-00472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2096","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA1","description":"ICD-BFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB0","description":"ICD-EELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was not obtained_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1029","description":"Imaging of the head (CT or MRI) was not obtained_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27345","description":"Removal of knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA0","description":"ICD-MGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","description":"HCPCS-J0013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA1","description":"ICD-KIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC1","description":"ICD-KIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remv&replc pm gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33229","description":"Remv&replc pm gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA0","description":"ICD-BDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ent procedure/service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92700","description":"Ent procedure/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE0","description":"ICD-OKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr ang lwr ext w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73725","description":"Mr ang lwr ext w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0774T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22600","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE1","description":"ICD-OARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE0","description":"ICD-GCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","description":"HCPCS-E0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1355","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB1","description":"ICD-MFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX45","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD1","description":"ICD-AFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF0","description":"ICD-PJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sps knee device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1811","description":"Sps knee device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93319","description":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF0","description":"ICD-AHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB1","description":"ICD-KCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ezderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4136","description":"Ezderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC1","description":"ICD-CBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA1","description":"ICD-BIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB1","description":"ICD-PGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment Benefits Counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1740","description":"Employment Benefits Counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue graft firsttooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4277","description":"Soft tissue graft firsttooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE0","description":"ICD-GIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB216","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE1","description":"ICD-GDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5113","description":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD1","description":"ICD-GABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove unilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1520","description":"Remove unilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ceftriaxone sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0696","description":"Ceftriaxone sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC0","description":"ICD-CAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB0","description":"ICD-OCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC1","description":"ICD-JAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC0","description":"ICD-CENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB0","description":"ICD-OLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC0","description":"ICD-AHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8A","description":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","description":"HCPCS-Q4429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA1","description":"ICD-MHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28240","description":"Release of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA0","description":"ICD-CFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Symphony_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2009","description":"Symphony_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respite care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9125","description":"Respite care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD0","description":"ICD-LEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40490","description":"Biopsy of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/markers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31626","description":"Bronchoscopy w/markers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue removal neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41145","description":"Tongue removal neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy supply misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4421","description":"Ostomy supply misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC0","description":"ICD-MIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB0","description":"ICD-BIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-3_n1-2noprg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9092","description":"Onc dx rectal t1-3_n1-2noprg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neoxflo or clarixflo 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4155","description":"Neoxflo or clarixflo 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33755","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB1","description":"ICD-OETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA11","description":"ICD-2BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF1","description":"ICD-FIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7190","description":"Factor viii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0851","description":"Pwc gp 3 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC1","description":"ICD-OKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25675","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID1","description":"ICD-IDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC17","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF0","description":"ICD-OJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81288","description":"Mlh1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cid transmit coil and cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8629","description":"Cid transmit coil and cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF0","description":"ICD-GALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35022","description":"Repair artery rupture chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF1","description":"ICD-KARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC1","description":"ICD-BCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp femoral-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35661","description":"Art byp femoral-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA1","description":"ICD-DFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB126","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC1","description":"ICD-KAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE0","description":"ICD-JAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE0","description":"ICD-EGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE0","description":"ICD-KAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF1","description":"ICD-GCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Keramatrix_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4165","description":"Keramatrix_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC0","description":"ICD-GGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE1","description":"ICD-EAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC0","description":"ICD-IBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain pancreatic pseudocyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48510","description":"Drain pancreatic pseudocyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabazitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9043","description":"Cabazitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38221","description":"Diagnostic bone marrow; biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0042","description":"Fos c chld non-ther per mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA1","description":"ICD-OAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8865","description":"Doc med reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE0","description":"ICD-DHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6224","description":"Gauze > 48 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epoprostenol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1325","description":"Epoprostenol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4224","description":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE1","description":"ICD-NKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB1","description":"ICD-NLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg bk ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5410","description":"Postop dsg bk ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF0","description":"ICD-FHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97036","description":"Hydrotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82979","description":"Assay rbc glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8043","description":"Upper facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC0","description":"ICD-HASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-inhalation drug for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7799","description":"Non-inhalation drug for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB0","description":"ICD-NFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB0","description":"ICD-GHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl measr scales jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1702","description":"Repl measr scales jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE0","description":"ICD-JBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28286","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88150","description":"Cytopath c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA0","description":"ICD-KDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0659","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","description":"HCPCS-E0659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC1","description":"ICD-FBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB0","description":"ICD-CEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE1","description":"ICD-EDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD1","description":"ICD-OBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corplex P_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4231","description":"Corplex P_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neisseria meningitidis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86741","description":"Neisseria meningitidis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE0","description":"ICD-AFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB1","description":"ICD-GEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA0","description":"ICD-IGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB1","description":"ICD-GGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE236","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22899","description":"Spine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC1","description":"ICD-NEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53854","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB0","description":"ICD-JEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD1","description":"ICD-BDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB0","description":"ICD-GELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD0","description":"ICD-KHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c seat lift mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0985","description":"W/c seat lift mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD1","description":"ICD-NATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF1","description":"ICD-FGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND1","description":"ICD-CFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOD1","description":"ICD-LCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA1","description":"ICD-OKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anti-reflective coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2750","description":"Anti-reflective coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC1","description":"ICD-GHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitor technol attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95956","description":"Eeg monitor technol attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Approp digoxin tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4189F","description":"Approp digoxin tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fecal microbiota_ live - jslm_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1440","description":"Fecal microbiota_ live - jslm_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB0","description":"ICD-JIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC1","description":"ICD-IFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening buprenorphine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80348","description":"Drug screening buprenorphine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD0","description":"ICD-EDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0B","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9790","description":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture lymphocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88230","description":"Tissue culture lymphocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hfo without joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3923","description":"Hfo without joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC0","description":"ICD-BGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX21","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4383","description":"Urinary rubber pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54324","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23570","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alefacept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0215","description":"Alefacept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF0","description":"ICD-HDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA1","description":"ICD-OKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC0","description":"ICD-FGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72192","description":"Ct pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0407","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0407","description":"CDT-D0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC1","description":"ICD-GEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21235","description":"Ear cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF1","description":"ICD-DGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Analysis skeletal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88355","description":"Analysis skeletal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD1","description":"ICD-CHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF0","description":"ICD-KGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE0","description":"ICD-FIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m teboroxime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9501","description":"Technetium tc-99m teboroxime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42660","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA1","description":"ICD-HFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD1","description":"ICD-JAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD1","description":"ICD-KFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB0","description":"ICD-FFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD1","description":"ICD-OHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC0","description":"ICD-KBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE1","description":"ICD-DCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96132","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8000","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8000","description":"HCPCS-C8000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB1","description":"ICD-KBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC1","description":"ICD-LIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA1","description":"ICD-NLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC0","description":"ICD-KGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC0","description":"ICD-FHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA1","description":"ICD-FDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1271","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","description":"HCPCS-J1271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC0","description":"ICD-GCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC0","description":"ICD-NBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA26","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC0","description":"ICD-CCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27704","description":"Removal of ankle implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9082","description":"Injection_ dostarlimab-gxly_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF1","description":"ICD-FEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD1","description":"ICD-BHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder fb deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23333","description":"Remove shoulder fb deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE1","description":"ICD-OHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD0","description":"ICD-CHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB0","description":"ICD-OLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF0","description":"ICD-CDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB1","description":"ICD-LDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF0","description":"ICD-NHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB1","description":"ICD-JDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27592","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8659","description":"Fun stat score ls >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF1","description":"ICD-MABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add le poly knee custom kafo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2387","description":"Add le poly knee custom kafo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1315","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA0","description":"ICD-MJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resolve Matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2024","description":"Resolve Matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0457","description":"Tlso flex trnk sj-ss pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dentures complete mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5120","description":"Dentures complete mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA0","description":"ICD-OGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD1","description":"ICD-GFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC1","description":"ICD-OFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percut ablate liver rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47382","description":"Percut ablate liver rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA1","description":"ICD-JATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2643","description":"Dental onlay porcelin 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29826","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA0","description":"ICD-PEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC104","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bursa of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28001","description":"Drainage of bursa of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R hrt coronary artery angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93456","description":"R hrt coronary artery angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF1","description":"ICD-OHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE1","description":"ICD-AFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ brachytx seed adm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1728","description":"Cath_ brachytx seed adm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD0","description":"ICD-NEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-hr_ no pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9073","description":"Onc dx brst stg3-hr_ no pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topical fluoride varnish","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1206","description":"Topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB1","description":"ICD-KEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/abn lvef b-bloc no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8452","description":"Pt w/abn lvef b-bloc no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD0","description":"ICD-CDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9993","description":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF1","description":"ICD-BFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1230","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43332","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0145U","description":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD1","description":"ICD-PKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal t4 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9097","description":"Onc dx esophageal t4 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC1","description":"ICD-OEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE0","description":"ICD-HCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144A","description":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA0","description":"ICD-EGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE1","description":"ICD-KIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF0","description":"ICD-NFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF0","description":"ICD-GHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72090","description":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC1","description":"ICD-IHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF1","description":"ICD-OIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE1","description":"ICD-BAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB0","description":"ICD-PJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE1","description":"ICD-OGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod or severe osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8846","description":"Mod or severe osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_onabotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0585","description":"Injection_onabotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB1","description":"ICD-LHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA1","description":"ICD-ADHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion suprfl any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15783","description":"Dermabrasion suprfl any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC1","description":"ICD-BGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB1","description":"ICD-CEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av fuse uppr arm basilic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36819","description":"Av fuse uppr arm basilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped power wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1239","description":"Ped power wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB1","description":"ICD-LFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC1","description":"ICD-HCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC1","description":"ICD-OKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB1","description":"ICD-HFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0845T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC0","description":"ICD-MLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME0","description":"ICD-FDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9065","description":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD0","description":"ICD-BDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB0","description":"ICD-KFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB31","description":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA112","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","description":"CPT-01190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF0","description":"ICD-DDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1643","description":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB1","description":"ICD-ACDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48140","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB1","description":"ICD-JDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC0","description":"ICD-GEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp <80 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3078F","description":"Diast bp <80 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND1","description":"ICD-NDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","description":"CPT-00220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94617","description":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0690T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD0","description":"ICD-IAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB0","description":"ICD-NBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0543U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","description":"CPT-0543U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC1","description":"ICD-KCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2103","description":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA201","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj reconstruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7858","description":"Tmj reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lube sterile packet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4332","description":"Lube sterile packet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Linezolid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2020","description":"Linezolid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA1","description":"ICD-EECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC1","description":"ICD-OBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF1","description":"ICD-OBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB1","description":"ICD-JGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hi enrgy eswt plantar fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28890","description":"Hi enrgy eswt plantar fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB1","description":"ICD-OJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA111","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47135","description":"Transplantation of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB0","description":"ICD-FCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE0","description":"ICD-HFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD1","description":"ICD-EIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4014","description":"Nephrology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD1","description":"ICD-MKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurovascular pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15750","description":"Neurovascular pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD1","description":"ICD-DHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC0","description":"ICD-OCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC215","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC0","description":"ICD-JALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE1","description":"ICD-GBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448T","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor inhibitor test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85335","description":"Factor inhibitor test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE1","description":"ICD-MFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of erythropoietin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82668","description":"Assay of erythropoietin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA0","description":"ICD-GCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","description":"HCPCS-G0568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA0","description":"ICD-MFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF1","description":"ICD-NABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA0","description":"ICD-FIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA1","description":"ICD-KDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj suprascapular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64418","description":"N block inj suprascapular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D7252","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7252","description":"CDT-D7252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37565","description":"Ligation of neck vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA0","description":"ICD-CFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD244","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF0","description":"ICD-EHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD1","description":"ICD-OEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA0","description":"ICD-OAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC1","description":"ICD-ODGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58356","description":"Endometrial cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA1","description":"ICD-MJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE0","description":"ICD-MLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE0","description":"ICD-ABBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB1","description":"ICD-NBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","description":"HCPCS-Q4380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54344","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA0","description":"ICD-OBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF0","description":"ICD-KEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open treatment of rib fracture without fixation_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21805","description":"Open treatment of rib fracture without fixation_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8B","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50961","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36216","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bmt harv/transpl 28d pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2150","description":"Bmt harv/transpl 28d pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_ uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8903","description":"MRI w/cont_ breast_ uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA0","description":"ICD-EIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23334","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA0","description":"ICD-FCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA0","description":"ICD-AGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscpy inj agent for incont","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377T","description":"Anoscpy inj agent for incont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66988","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD1","description":"ICD-NKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care 4 pain docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521F","description":"Plan of care 4 pain docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect vag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57285","description":"Repair paravag defect vag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect femur/knee tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27365","description":"Resect femur/knee tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF0","description":"ICD-GEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE155","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2216","description":"Foam filled propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bumetanide_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1939","description":"Injection_ bumetanide_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE1","description":"ICD-JDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE0","description":"ICD-FACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA0","description":"ICD-IDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99423","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD1","description":"ICD-GFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD1","description":"ICD-GDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD1","description":"ICD-GHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF1","description":"ICD-FHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0247","description":"Trans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60240","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF1","description":"ICD-BEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD0","description":"ICD-JFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35879","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC0","description":"ICD-NFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE0","description":"ICD-DHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert bladder cath complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51703","description":"Insert bladder cath complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97158","description":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21445","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary/tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58720","description":"Removal of ovary/tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF0","description":"ICD-IGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF1","description":"ICD-GAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9085","description":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rec cortico>60d or 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9469","description":"Rec cortico>60d or 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort ii anterior intrusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21150","description":"Lefort ii anterior intrusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90740","description":"Hepb vacc 3 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD1","description":"ICD-JCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB0","description":"ICD-OKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD1","description":"ICD-OHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE1","description":"ICD-NENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1217","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Piperacillin/tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2543","description":"Piperacillin/tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","description":"HCPCS-M1472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB1","description":"ICD-FHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23650","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26746","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Qty act diab retin mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9672","description":"Qty act diab retin mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00172","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","description":"CPT-00172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4268","description":"Surgraft ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95925","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA1","description":"ICD-MKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroglobulin antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86800","description":"Thyroglobulin antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colchicine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0760","description":"Colchicine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC0","description":"ICD-ICAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC0","description":"ICD-CHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF1","description":"ICD-FDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF1","description":"ICD-EGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA1","description":"ICD-FEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE1","description":"ICD-BFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB1","description":"ICD-OHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73040","description":"Contrast x-ray of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transport portable ekg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0076","description":"Transport portable ekg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0662","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","description":"HCPCS-G0662","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lambswool sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0189","description":"Lambswool sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC1","description":"ICD-KHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA0","description":"ICD-LDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86052","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC1","description":"ICD-OFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt immunity to hep b docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3216F","description":"Pt immunity to hep b docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81307","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB0","description":"ICD-NITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB1","description":"ICD-GFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX40","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Talk re uv light pt/crgvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4176F","description":"Talk re uv light pt/crgvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF0","description":"ICD-JFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA45","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of omentum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49255","description":"Removal of omentum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB1","description":"ICD-GBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB0","description":"ICD-JGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF1","description":"ICD-AHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo state","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9151","description":"Mapcp demo state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF1","description":"ICD-LHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8575","description":"Postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9258","description":"Doc stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD1","description":"ICD-MGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11421","description":"Exc h-f-nk-sp b9+marg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","description":"HCPCS-Q4410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA0","description":"ICD-NALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD1","description":"ICD-OKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9738","description":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA0","description":"ICD-CGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smear fluorescent/acid stai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87206","description":"Smear fluorescent/acid stai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cover bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5704","description":"Custom shape cover bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl artific disc addl crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095T","description":"Rmvl artific disc addl crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC1","description":"ICD-NDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD0","description":"ICD-CGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE1","description":"ICD-GFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive pills for bc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4993","description":"Contraceptive pills for bc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA0","description":"ICD-PDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF1","description":"ICD-MCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB1","description":"ICD-ODIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE0","description":"ICD-KFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Melphalan oral 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8600","description":"Melphalan oral 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC1","description":"ICD-GENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/staple esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43405","description":"Ligate/staple esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC1","description":"ICD-EBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic radiation trmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77432","description":"Stereotactic radiation trmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD0","description":"ICD-AIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9903","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/90d mrs >2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9648","description":"Pt w/90d mrs >2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE1","description":"ICD-DGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE1","description":"ICD-OJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6710","description":"Crown-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC0","description":"ICD-EAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB0","description":"ICD-NEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE1","description":"ICD-PIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB1","description":"ICD-KASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tray w/o bag/cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4310","description":"Insert tray w/o bag/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD0","description":"ICD-PLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC1","description":"ICD-IDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lpn/lvn services up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1003","description":"Lpn/lvn services up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ udenyca 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5111","description":"Injection_ udenyca 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Creatinine clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82575","description":"Creatinine clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD0","description":"ICD-GESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of orbit (transcranial approach); with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61332","description":"Exploration of orbit (transcranial approach); with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA0","description":"ICD-CAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50382","description":"Change ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE0","description":"ICD-BDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip/thigh fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27025","description":"Incision of hip/thigh fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF1","description":"ICD-NELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE0","description":"ICD-FDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36572","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm>= 400mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9964","description":"Hocm>= 400mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27829","description":"Treat lower leg joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neonatal emergency transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0225","description":"Neonatal emergency transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC1","description":"ICD-NJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA1","description":"ICD-MALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quant her2 ihc eval brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3394F","description":"Quant her2 ihc eval brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2250","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including interpretation with follow-up with the patient withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES154","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE1","description":"ICD-CEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9174","description":"Speech lang current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB31","description":"ICD-3AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF1","description":"ICD-BCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24371","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE1","description":"ICD-BGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0800","description":"Pov group 1 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 4 visits p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90960","description":"Esrd srv 4 visits p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB0","description":"ICD-OIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4265","description":"Paraffin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deferoxamine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0895","description":"Deferoxamine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99072","description":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95852","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA0","description":"ICD-IFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA0","description":"ICD-IGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1014","description":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC0","description":"ICD-GBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA1","description":"ICD-FAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81223","description":"Cftr gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 3 yrs plus im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90688","description":"Iiv4 vaccine 3 yrs plus im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93612","description":"Intraventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin immune fab (ovine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1162","description":"Digoxin immune fab (ovine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL21","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA1","description":"ICD-JCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF0","description":"ICD-BBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp femoral-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35656","description":"Art byp femoral-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA1","description":"ICD-ACUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF0","description":"ICD-CBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay porc/crmc 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6608","description":"Onlay porc/crmc 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC1","description":"ICD-DGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Accessing and retorquing loose implant screw - per screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6089","description":"Accessing and retorquing loose implant screw - per screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF1","description":"ICD-AAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53230","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0686U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686U","description":"CPT-0686U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy uv-a or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96913","description":"Photochemotherapy uv-a or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB0","description":"ICD-FAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF1","description":"ICD-OHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6794","description":"Crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dextran 75 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7110","description":"Dextran 75 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC0","description":"ICD-BFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB120","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transportation costs to and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9992","description":"Transportation costs to and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC0","description":"ICD-NCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID1","description":"ICD-BGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA1","description":"ICD-NJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD1","description":"ICD-KEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD0","description":"ICD-BGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF1","description":"ICD-OCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Centerbased day care perdiem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5105","description":"Centerbased day care perdiem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB0","description":"ICD-BCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3a no progre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9065","description":"Onc dx nsclc stg3a no progre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE1","description":"ICD-EHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF0","description":"ICD-FCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA1","description":"ICD-IEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28124","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB1","description":"ICD-GFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE1","description":"ICD-MELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74220","description":"Contrast x-ray esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE0","description":"ICD-OFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1238","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID0","description":"ICD-FCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6594","description":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC0","description":"ICD-OHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB1","description":"ICD-DCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA0","description":"ICD-KFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE0","description":"ICD-OGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8G","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8D","description":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of c-peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84681","description":"Assay of c-peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88364","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB31","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD0","description":"ICD-NIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tonsil tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42860","description":"Excision of tonsil tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB1","description":"ICD-OGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28304","description":"Incision of midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE130","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fev<60% pred & copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8924","description":"Fev<60% pred & copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound warming wound cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6000","description":"Wound warming wound cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB0","description":"ICD-EADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8042","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg & 1 cast chg ak/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5420","description":"Postop dsg & 1 cast chg ak/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9610","description":"HCPCS-C9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE0","description":"ICD-KDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA1","description":"ICD-EHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apligraf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4101","description":"Apligraf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc iliac art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238T","description":"Trluml perip athrc iliac art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB0","description":"ICD-MELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC0","description":"ICD-JEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC0","description":"ICD-GCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capture tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0384","description":"Cone beam ct capture tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","description":"HCPCS-Q4414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8470","description":"Pros sock single ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF1","description":"ICD-CFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC55","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB0","description":"ICD-MFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92603","description":"Cochlear implt f/up exam 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC1","description":"ICD-OBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB1","description":"ICD-OJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Circumcision neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54160","description":"Circumcision neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC1","description":"ICD-IIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rufinamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80210","description":"Rufinamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD1","description":"ICD-EHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF1","description":"ICD-IFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD0","description":"ICD-KGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF1","description":"ICD-LIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0911T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","description":"CPT-0911T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF1","description":"ICD-FHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29822","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of umbilicus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49250","description":"Excision of umbilicus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control band & belt u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2630","description":"Pelvic control band & belt u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng periton dialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4055F","description":"Pt rcvng periton dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC0","description":"ICD-MBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","description":"HCPCS-Q4383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE0","description":"ICD-BBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD0","description":"ICD-FGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB251","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual wc hand rim w project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0967","description":"Manual wc hand rim w project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF1","description":"ICD-AFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE0","description":"ICD-FBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7634","description":"Budesonide comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE1","description":"ICD-BCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD0","description":"ICD-CFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of rbc galactokinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82759","description":"Assay of rbc galactokinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME0","description":"ICD-MAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE0","description":"ICD-OBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manipulation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27275","description":"Manipulation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31287","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20969","description":"Bone/skin graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99304","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC0","description":"ICD-OAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90674","description":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD1","description":"ICD-FCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC0","description":"ICD-NHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD1","description":"ICD-JGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF1","description":"ICD-LBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 7 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP07","description":"Auto.test pane pricing code_ 7 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC0","description":"ICD-KEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31254","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA0","description":"ICD-IDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0404","description":"CDT-D0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED1","description":"ICD-OHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB55","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA1","description":"ICD-IBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF1","description":"ICD-BEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity high","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3472F","description":"Ra disease activity high","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4149F","description":"Hep b vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD0","description":"ICD-NJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB1","description":"ICD-CIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD0","description":"ICD-MKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Additional switch_ ext power","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6611","description":"Additional switch_ ext power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE1","description":"ICD-EEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2163","description":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA1","description":"ICD-AHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC31","description":"ICD-2BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor five anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81512","description":"Ftl cgen abnor five anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi norm parameters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8420","description":"Calc bmi norm parameters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic immitance testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92570","description":"Acoustic immitance testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5213","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB0","description":"ICD-MDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44360","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB0","description":"ICD-KIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD1","description":"ICD-BIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD0","description":"ICD-CEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No elig tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8601","description":"No elig tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0327U","description":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC0","description":"ICD-FCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA0","description":"ICD-KIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrnd hgh-risk sex behav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4293F","description":"Pt scrnd hgh-risk sex behav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB0","description":"ICD-AFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aquatic therapy/exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97113","description":"Aquatic therapy/exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of lymph channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38308","description":"Incision of lymph channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9815","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9815","description":"HCPCS-C9815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"22nf nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2360","description":"22nf nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF1","description":"ICD-OFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB1","description":"ICD-CEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE1","description":"ICD-GFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD0","description":"ICD-KAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum dep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27634","description":"Exc leg/ankle tum dep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE0","description":"ICD-BBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dev delay prev dp ch_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2037","description":"Dev delay prev dp ch_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB1","description":"ICD-NIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB150","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD0","description":"ICD-ACHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF0","description":"ICD-CEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE1","description":"ICD-IATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21142","description":"Lefort i-2 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA0","description":"ICD-CCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17261","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vinblastine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9360","description":"Vinblastine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC0","description":"ICD-PGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61312","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA1","description":"ICD-GHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF1","description":"ICD-CDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE1","description":"ICD-EEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF0","description":"ICD-NKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC THYR MRNA XPRSN ALYS 593","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0204U","description":"ONC THYR MRNA XPRSN ALYS 593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE0","description":"ICD-GHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND0","description":"ICD-JHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal topography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92025","description":"Corneal topography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF0","description":"ICD-NLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1402","description":"HCPCS-B1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC1","description":"ICD-KAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE1","description":"ICD-OIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC1","description":"ICD-LESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","description":"HCPCS-Q4393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC0","description":"ICD-MGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD1","description":"ICD-JEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"1x scrn hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9451","description":"1x scrn hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64792","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7922","description":"Placement Of Intra-Socket Biological Dressing To Aid In Hemostasis Or Clot Stabiliization_ Per Site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA1","description":"ICD-MLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED1","description":"ICD-MDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC1","description":"ICD-BEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing antigen system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86911","description":"Blood typing antigen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF0","description":"ICD-AABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enverse_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4258","description":"Enverse_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB31","description":"ICD-4EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted preventive service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99429","description":"Unlisted preventive service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL50","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip joint adjustable flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2622","description":"Hip joint adjustable flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA0","description":"ICD-LHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE1","description":"ICD-NCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93017","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC1","description":"ICD-GCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA35","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX56","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD1","description":"ICD-IFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline pwr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1005","description":"Pwr seat recline pwr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA0","description":"ICD-DDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC155","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD0","description":"ICD-NIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA0","description":"ICD-IGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD1","description":"ICD-CEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9303","description":"Norsn no pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0758T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC0","description":"ICD-MLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Procarbazine_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0182","description":"Procarbazine_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB0","description":"ICD-CCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","description":"CPT-00670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE1","description":"ICD-BAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33275","description":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9513","description":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46753","description":"Reconstruction of anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE0","description":"ICD-MCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eps Gast Cardia Plic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9724","description":"Eps Gast Cardia Plic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE1","description":"ICD-OJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA0","description":"ICD-CEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD1","description":"ICD-ECMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB0","description":"ICD-KFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF1","description":"ICD-KDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE0","description":"ICD-CGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0525U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","description":"CPT-0525U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1094","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","description":"HCPCS-Q5151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC1","description":"ICD-OLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB0","description":"ICD-NLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in hospice facility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5006","description":"Hospice in hospice facility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB1","description":"ICD-NGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77402","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Brexanolone_ 1Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9055","description":"Injection_ Brexanolone_ 1Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9979","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA0","description":"ICD-GADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB210","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD1","description":"ICD-NEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0630","description":"Removal of sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect back tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21935","description":"Resect back tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB0","description":"ICD-NLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC1","description":"ICD-GBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major Abdominal Blood Vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77059","description":"Major Abdominal Blood Vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD0","description":"ICD-GEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD0","description":"ICD-IEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF1","description":"ICD-NAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31770","description":"Repair/graft of bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA0","description":"ICD-BHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD0","description":"ICD-JATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB0","description":"ICD-BFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19300","description":"Removal of breast tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD0","description":"ICD-LARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND1","description":"ICD-KDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC1","description":"ICD-BCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF1","description":"ICD-CCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE1","description":"ICD-KIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0971T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","description":"CPT-0971T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA21","description":"ICD-3HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB0","description":"ICD-IHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF0","description":"ICD-OGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50328","description":"Prep renal graft/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD0","description":"ICD-GISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe dennis browne splint bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3640","description":"Shoe dennis browne splint bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF1","description":"ICD-CEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4030","description":"Cast sup long leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 3 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34843","description":"Endovasc visc aorta 3 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB0","description":"ICD-OEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of speech fluency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92521","description":"Evaluation of speech fluency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56620","description":"Partial removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME1","description":"ICD-BHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko single upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0901","description":"Ko single upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo cap desgn w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3977","description":"Sewhfo cap desgn w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","description":"HCPCS-Q5150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA1","description":"ICD-BGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA1","description":"ICD-GBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA1","description":"ICD-CCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE0","description":"ICD-FBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26755","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE0","description":"ICD-GIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket brim cust fit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4030","description":"Replace socket brim cust fit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD1","description":"ICD-JFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED0","description":"ICD-NAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD0","description":"ICD-DEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD1","description":"ICD-FIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF1","description":"ICD-DEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ other than trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1898","description":"Lead_ pmkr_ other than trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1444","description":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID1","description":"ICD-OKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD0","description":"ICD-CFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB113","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC1","description":"ICD-KCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB1","description":"ICD-NFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no preop assmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9616","description":"Doc rsn no preop assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","description":"HCPCS-M1383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo below knee alignable sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5910","description":"Endo below knee alignable sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sec art thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37186","description":"Sec art thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis w/huhner","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89300","description":"Semen analysis w/huhner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB0","description":"ICD-FEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB0","description":"ICD-LHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67414","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB1","description":"ICD-CDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2006","description":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC1","description":"ICD-AHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65730","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61320","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60280","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bed pan standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0275","description":"Bed pan standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88333","description":"Intraop cyto path consult 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB0","description":"ICD-GBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2004","description":"HCPCS-B2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE110","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC1","description":"ICD-MBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC1","description":"ICD-CFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE0","description":"ICD-NFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA1","description":"ICD-FBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF1","description":"ICD-GCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC1","description":"ICD-CEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA1","description":"ICD-OHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD1","description":"ICD-JIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB25","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9608","description":"Perc d-e cor revasc chro add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE0","description":"ICD-OCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE1","description":"ICD-BABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33256","description":"Ablate atria w/bypass exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52451","description":"Anesth chest drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE0","description":"ICD-PCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA1","description":"ICD-BEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC1","description":"ICD-CCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acute pvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1337","description":"Acute pvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27093","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31780","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB0","description":"ICD-BANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD1","description":"ICD-EDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6065","description":"Implant supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73130","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab porc/ceram crown pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2929","description":"Prefab porc/ceram crown pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF0","description":"ICD-FGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interstitial radioelement application; simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77776","description":"Interstitial radioelement application; simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF1","description":"ICD-OCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB0","description":"ICD-MFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65235","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE0","description":"ICD-GEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB0","description":"ICD-ICTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67835","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99354","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD1","description":"ICD-KHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC1","description":"ICD-JGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE1","description":"ICD-NLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC0","description":"ICD-CHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99377","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB0","description":"ICD-LDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA0","description":"ICD-JCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF1","description":"ICD-BGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED0","description":"ICD-GEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal pacemaker electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33235","description":"Removal pacemaker electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303T","description":"Icar ischm mntrng sys eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD131","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve_ inter limb comp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4600","description":"Sleeve_ inter limb comp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision benign lesion>1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7411","description":"Excision benign lesion>1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC1","description":"ICD-MAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE135","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80335","description":"Antidepressant tricyclic 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC1","description":"ICD-KAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient exhibits 2 or more risk factors for postoperative vomiting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9954","description":"Patient exhibits 2 or more risk factors for postoperative vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43886","description":"Revise gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2102","description":"HCPCS-A2102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA1","description":"ICD-FIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF0","description":"ICD-HEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB0","description":"ICD-NAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application lower leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29515","description":"Application lower leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj carotid subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35695","description":"Art trnsposj carotid subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC0","description":"ICD-NAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF1","description":"ICD-KFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of leg veins/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37735","description":"Removal of leg veins/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroguide for vein device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77001","description":"Fluoroguide for vein device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHC1","description":"ICD-GFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PalinGen or PalinGen XPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4173","description":"PalinGen or PalinGen XPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95718","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF0","description":"ICD-CHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB236","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD1","description":"ICD-JBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze>16 <= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6403","description":"Sterile gauze>16 <= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21470","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA0","description":"ICD-OBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38227","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","description":"CPT-38227","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver image (3d) with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78206","description":"Liver image (3d) with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc with wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8912","description":"Pt doc with wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE1","description":"ICD-NJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38724","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB1","description":"ICD-CHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personal care ser per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1020","description":"Personal care ser per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personal care item nos each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5199","description":"Personal care item nos each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA1","description":"ICD-GGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE0","description":"ICD-NDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF0","description":"ICD-MEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD0","description":"ICD-FDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB1","description":"ICD-GIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC0","description":"ICD-CADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF1","description":"ICD-KBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE1","description":"ICD-CBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33254","description":"Ablate atria lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cell marker study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88182","description":"Cell marker study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB0","description":"ICD-NCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA1","description":"ICD-EDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19328","description":"Removal of breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE0","description":"ICD-EDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE0","description":"ICD-JDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27630","description":"Removal of tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX41","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA1","description":"ICD-GAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB241","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC1","description":"ICD-ODLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (qual)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83630","description":"Lactoferrin fecal (qual)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE0","description":"ICD-GCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE0","description":"ICD-MJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC1","description":"ICD-JIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA60","description":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","description":"CPT-01730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB1","description":"ICD-MEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","description":"CPT-01120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417U","description":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep b core antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86705","description":"Hep b core antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE1","description":"ICD-IACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3973","description":"Sewho airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE121","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96118","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA36","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Florbetaben f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9458","description":"Florbetaben f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC1","description":"ICD-KCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD0","description":"ICD-CAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF0","description":"ICD-IAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cathepsin-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82387","description":"Assay of cathepsin-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 3 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34847","description":"Visc & infraren abd 3 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX41","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA0","description":"ICD-JHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1082","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC0","description":"ICD-EAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9836","description":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC1","description":"ICD-OLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pseudoaneurysm injection trt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36002","description":"Pseudoaneurysm injection trt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA1","description":"ICD-OFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA1","description":"ICD-CIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE111","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE1","description":"ICD-CBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF1","description":"ICD-OGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC0","description":"ICD-ODHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE1","description":"ICD-ODXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unite biomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4129","description":"Unite biomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA1","description":"ICD-OGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna hiv reverse t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87901","description":"Genotype dna hiv reverse t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE0","description":"ICD-ADDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE0","description":"ICD-DDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinnervate larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31590","description":"Reinnervate larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF1","description":"ICD-GCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB1","description":"ICD-ACLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2205","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE1","description":"ICD-BHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB0","description":"ICD-CIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB0","description":"ICD-NKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7328","description":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0547U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","description":"CPT-0547U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF1","description":"ICD-KIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73580","description":"Contrast x-ray of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC0","description":"ICD-JCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA1","description":"ICD-DEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC0","description":"ICD-AGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Central dexa ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3096F","description":"Central dexa ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE1","description":"ICD-JIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0522","description":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25272","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery w/tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33505","description":"Repair artery w/tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE0","description":"ICD-OHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA1","description":"ICD-KEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB1","description":"ICD-OAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8808","description":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a transplant prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1262","description":"Patients who had a transplant prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB1","description":"ICD-KCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC1","description":"ICD-FITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC1","description":"ICD-CFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF0","description":"ICD-FAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF1","description":"ICD-KAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE1","description":"ICD-OAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr tiller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0984","description":"Add pwr tiller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62320","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77057","description":"Mammogram screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9117","description":"Onc dx ovarian unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB1","description":"ICD-EHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB0","description":"ICD-FBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC1","description":"ICD-KBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA0","description":"ICD-FCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC0","description":"ICD-FANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23465","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0644","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0644","description":"HCPCS-J0644","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1005","description":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA0","description":"ICD-NLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL51","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6071","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF1","description":"ICD-GFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB0","description":"ICD-OBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC0","description":"ICD-JAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB1","description":"ICD-AACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019M","description":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of troponin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84484","description":"Assay of troponin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of nail fold toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11765","description":"Excision of nail fold toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE1","description":"ICD-KAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE1","description":"ICD-PIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC0","description":"ICD-KIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE0","description":"ICD-ECCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC0","description":"ICD-FIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6596","description":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC0","description":"ICD-JAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFF0","description":"ICD-KAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB0","description":"ICD-EDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA0","description":"ICD-ICAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA1","description":"ICD-FGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hook vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6706","description":"Term dev mech hook vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23076","description":"Exc shoulder tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD1","description":"ICD-AALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB1","description":"ICD-JIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC0","description":"ICD-CHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC0","description":"ICD-AGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ artesunate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0391","description":"Injection_ artesunate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert epicard eltrd open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33202","description":"Insert epicard eltrd open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5171","description":"HCPCS-Q5171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9153","description":"Multi-vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70540","description":"MRI orbit/face/neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63066","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC0","description":"ICD-CISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28606","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62323","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB1","description":"ICD-FIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE1","description":"ICD-LIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE1","description":"ICD-CHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50135","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD1","description":"ICD-NBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA0","description":"ICD-OEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE0","description":"ICD-OGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1009","description":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 6 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP06","description":"Auto.test pane pricing code_ 6 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB1","description":"ICD-NATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interferential stim 4 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8131","description":"Interferential stim 4 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF0","description":"ICD-EFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243T","description":"Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s)_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF1","description":"ICD-NJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA0","description":"ICD-KFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ArdeoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4333","description":"ArdeoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA213","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD0","description":"ICD-HHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use txmnt pharmacol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4001F","description":"Tobacco use txmnt pharmacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF1","description":"ICD-BEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51840","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF0","description":"ICD-FGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supports brokerage_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2051","description":"Supports brokerage_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB0","description":"ICD-DEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC212","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add to spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0999","description":"Add to spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD0","description":"ICD-PGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38381","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE0","description":"ICD-GGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mannitol for inhaler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7665","description":"Mannitol for inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30110","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD0","description":"ICD-EABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE1","description":"ICD-EBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33368","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381U","description":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27507","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5142","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","description":"HCPCS-Q5142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot non-standard size/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3255","description":"Orth foot non-standard size/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB0","description":"ICD-IFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF1","description":"ICD-FFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB0","description":"ICD-CHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac cond noadd by guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9061","description":"Onc prac cond noadd by guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5939","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5939","description":"CDT-D5939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA0","description":"ICD-ODKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE1","description":"ICD-JHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE114","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME1","description":"ICD-KDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE1","description":"ICD-OHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA0","description":"ICD-MBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt & graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33764","description":"Major vessel shunt & graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC1","description":"ICD-MIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o contr_ cont ecg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8930","description":"Tte w or w/o contr_ cont ecg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA0","description":"ICD-CGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61860","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB1","description":"ICD-OJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC31","description":"ICD-4GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gba gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81251","description":"Gba gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7740","description":"Clsd reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE1","description":"ICD-OIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0516U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","description":"CPT-0516U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE1","description":"ICD-BFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE141","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD1","description":"ICD-MFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD0","description":"ICD-OAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE0","description":"ICD-CETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cervical cap contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4261","description":"Cervical cap contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ringers lactate infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7120","description":"Ringers lactate infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB0","description":"ICD-CITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF1","description":"ICD-KIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF0","description":"ICD-JEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31257","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF0","description":"ICD-CIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF0","description":"ICD-OCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA0","description":"ICD-ACEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lat lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22533","description":"Lat lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fosaprepitant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1453","description":"Fosaprepitant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD1","description":"ICD-GERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA1","description":"ICD-CAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1060","description":"Thoracic pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulm funct test oscillometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94728","description":"Pulm funct test oscillometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC0","description":"ICD-OABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB1","description":"ICD-GCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy biceps tenodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29828","description":"Arthroscopy biceps tenodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0568T","description":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD0","description":"ICD-OEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Loudness balance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92562","description":"Loudness balance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace implantable hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053T","description":"Replace implantable hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bupropion hcl sr 60 tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0106","description":"Bupropion hcl sr 60 tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB0","description":"ICD-KIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth esophageal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50051","description":"Anesth esophageal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA0","description":"ICD-FGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA0","description":"ICD-JEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop colon lavage add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44701","description":"Intraop colon lavage add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC0","description":"ICD-BFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004U","description":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC1","description":"ICD-NKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE245","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE1","description":"ICD-LEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA0","description":"ICD-LHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vaginal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57415","description":"Remove vaginal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-60661","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","description":"CPT-60661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86053","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External recharg sys intern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8689","description":"External recharg sys intern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA0","description":"ICD-MFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC0","description":"ICD-CAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25660","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF0","description":"ICD-JEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA1","description":"ICD-GDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2173","description":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD0","description":"ICD-PHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36471","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015U","description":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD0","description":"ICD-CDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess cat in dbase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7020F","description":"Mammo assess cat in dbase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE1","description":"ICD-JDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6507","description":"Cmprs burngarment foot-knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Per pm reeval est pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99391","description":"Per pm reeval est pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF0","description":"ICD-MDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetazolamid sodium injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1120","description":"Acetazolamid sodium injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA0","description":"ICD-GARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD1","description":"ICD-JEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE1","description":"ICD-DFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8A","description":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2093","description":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA1","description":"ICD-EEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE1","description":"ICD-KFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD0","description":"ICD-KIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE1","description":"ICD-NKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA1","description":"ICD-JIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4C","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD0","description":"ICD-CBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF0","description":"ICD-EACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA1","description":"ICD-EBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC213","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD0","description":"ICD-KCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N-et; commerc carrier pass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2004","description":"N-et; commerc carrier pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay serum cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82480","description":"Assay serum cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA1","description":"ICD-MJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB151","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB1","description":"ICD-BBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30465","description":"Repair nasal stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6593","description":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX53","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast hi noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2780","description":"Crown 3/4 cast hi noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63268","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28496","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC1","description":"ICD-NKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB0","description":"ICD-KEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1806","description":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE1","description":"ICD-CBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE0","description":"ICD-JIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE0","description":"ICD-MAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral con def mod palat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5959","description":"Intraoral con def mod palat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB1","description":"ICD-BHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of theophylline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80198","description":"Assay of theophylline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0B","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA0","description":"ICD-KHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD0","description":"ICD-GCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF0","description":"ICD-PGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE1","description":"ICD-CCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC1","description":"ICD-KCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE1","description":"ICD-NCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF1","description":"ICD-PDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF1","description":"ICD-NAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87340","description":"IAAD IA HEPATITIS B SURFACE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27228","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37252","description":"Intrvasc us noncoronary 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC0","description":"ICD-ACLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD1","description":"ICD-KATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA155","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Puncture drainage of lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10160","description":"Puncture drainage of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95149","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6590","description":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB1","description":"ICD-EGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD1","description":"ICD-GGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w/o barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5072","description":"Urinary pouch w/o barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB1","description":"ICD-GDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whfo nontorsion joint prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3931","description":"Whfo nontorsion joint prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52290","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE0","description":"ICD-GAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2982","description":"Onlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24101","description":"Explore/treat elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48548","description":"Fuse pancreas and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD0","description":"ICD-JDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE1","description":"ICD-OLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF1","description":"ICD-PHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lipopro bld electrophoretic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83700","description":"Lipopro bld electrophoretic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE0","description":"ICD-AGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunodiffusion ouchterlony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86331","description":"Immunodiffusion ouchterlony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB1","description":"ICD-EIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC1","description":"ICD-MEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab and hyaluronidase_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9467","description":"Injection_ rituximab and hyaluronidase_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB0","description":"ICD-BCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leveen/shunt patency exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78291","description":"Leveen/shunt patency exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9043","description":"Injection_ levoleucovorin_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF0","description":"ICD-IIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE0","description":"ICD-MJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost clsd pouch w att st barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4387","description":"Ost clsd pouch w att st barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA0","description":"ICD-CDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4106","description":"Dermagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD1","description":"ICD-BFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cult epiderm grft f/n/hfg +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15157","description":"Cult epiderm grft f/n/hfg +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB0","description":"ICD-EFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB0","description":"ICD-PJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE0","description":"ICD-BAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE0","description":"ICD-NJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB0","description":"ICD-JHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD0","description":"ICD-ACCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3B","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80143","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC1","description":"ICD-GIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy nos/day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5181","description":"Hh respiratory thrpy nos/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB1","description":"ICD-CIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE0","description":"ICD-IBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC0","description":"ICD-GDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE1","description":"ICD-GDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF0","description":"ICD-BIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD0","description":"ICD-OFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0969T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","description":"CPT-0969T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME0","description":"ICD-KHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC0","description":"ICD-MCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93018","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No dxa no med hx no rv sx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9472","description":"No dxa no med hx no rv sx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD1","description":"ICD-OJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF1","description":"ICD-CCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9156","description":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA1","description":"ICD-CGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Robt lin-radsurg fractx 2-5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0340","description":"Robt lin-radsurg fractx 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD1","description":"ICD-HGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA0","description":"ICD-DEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA0","description":"ICD-KCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE0","description":"ICD-GECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33361","description":"Replace aortic valve perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens pmma bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2502","description":"Contact lens pmma bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA0","description":"ICD-CHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic pre one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0490","description":"Tlso rigid plastic pre one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF0","description":"ICD-KBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB1","description":"ICD-EHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF0","description":"ICD-FDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF0","description":"ICD-GIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB156","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA0","description":"ICD-OGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3250","description":"Trimethobenzamide hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA0","description":"ICD-KHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC1","description":"ICD-NJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0103","description":"HCPCS-B0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/ th nrv exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32664","description":"Thoracoscopy w/ th nrv exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orbit surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67599","description":"Orbit surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11446","description":"Exc face-mm b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81402","description":"Mopath procedure level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC1","description":"ICD-NIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD0","description":"ICD-GCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB1","description":"ICD-NDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81168","description":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA36","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE1","description":"ICD-BDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA0","description":"ICD-BBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA1","description":"ICD-GIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TDD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5272","description":"TDD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF0","description":"ICD-GCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC1","description":"ICD-FBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fondaparinux sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1652","description":"Fondaparinux sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD1","description":"ICD-PESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA1","description":"ICD-JBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25107","description":"Remove wrist joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 known familial variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81318","description":"Pms2 known familial variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB1","description":"ICD-OCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho post-op hip abduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1686","description":"Ho post-op hip abduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF1","description":"ICD-OCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC1","description":"ICD-JIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74400","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC0","description":"ICD-JGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF0","description":"ICD-JDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA0","description":"ICD-GCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA0","description":"ICD-JIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD1","description":"ICD-OKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61592","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA1","description":"ICD-ODWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC1","description":"ICD-JCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA0","description":"ICD-NCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC1","description":"ICD-KDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC0","description":"ICD-CBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB1","description":"ICD-JCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Variable concentration mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4620","description":"Variable concentration mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7535","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF0","description":"ICD-CDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB0","description":"ICD-CFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD1","description":"ICD-BAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE211","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 7-8 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95910","description":"Nrv cndj test 7-8 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE1","description":"ICD-KHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cranial surg nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21051","description":"Anesth cranial surg nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD116","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flexible brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43200","description":"Esophagoscopy flexible brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB1","description":"ICD-IAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt=d(rh)+ or sensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3291F","description":"Pt=d(rh)+ or sensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Mechanical Prosthetic Heart Valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0043","description":"Patients With Mechanical Prosthetic Heart Valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA0","description":"ICD-KIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA0","description":"ICD-EFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD1","description":"ICD-GGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy internal hemorrhoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46930","description":"Destroy internal hemorrhoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD0","description":"ICD-PAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","description":"CPT-00936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE0","description":"ICD-KBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9764","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF1","description":"ICD-NFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath indw foley 3 way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4346","description":"Cath indw foley 3 way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81304","description":"Mecp2 gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1303","description":"HCPCS-A1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB0","description":"ICD-GEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB1","description":"ICD-IIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC0","description":"ICD-IETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27132","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND1","description":"ICD-JGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME1","description":"ICD-IAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC21","description":"ICD-4IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97153","description":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB1","description":"ICD-GGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX12","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1039","description":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0643T","description":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA0","description":"ICD-GFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE0","description":"ICD-GHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal scrn; hi risk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0105","description":"Colorectal scrn; hi risk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9914","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9914","description":"CDT-D9914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE1","description":"ICD-OAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55535","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA0","description":"ICD-NKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62258","description":"Replace brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE1","description":"ICD-JCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED0","description":"ICD-NEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB1","description":"ICD-MIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryotherapy of skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17340","description":"Cryotherapy of skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE1","description":"ICD-EACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB0","description":"ICD-NFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6581","description":"Gradient compression glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB1","description":"ICD-KHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA0","description":"ICD-PBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB1","description":"ICD-OATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ sock above elb/dis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6688","description":"Frame typ sock above elb/dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE1","description":"ICD-FDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appl desensitizing resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9911","description":"Appl desensitizing resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct skin color ea 20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11922","description":"Correct skin color ea 20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relieve inner eye pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65820","description":"Relieve inner eye pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB0","description":"ICD-OGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF0","description":"ICD-EDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24546","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC0","description":"ICD-JANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4A","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5164","description":"HCPCS-Q5164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9321","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC244","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pin hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26676","description":"Pin hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA1","description":"ICD-CHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA1","description":"ICD-KARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES206","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE1","description":"ICD-GFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF1","description":"ICD-KHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99364","description":"Anticoagulant mgmt subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1361","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD0","description":"ICD-GCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC0","description":"ICD-GDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther fx nasal inf turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30930","description":"Ther fx nasal inf turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath concentrate tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88108","description":"Cytopath concentrate tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA0","description":"ICD-OJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pml/raralpha com breakpoints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81315","description":"Pml/raralpha com breakpoints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain cavity shunt w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62201","description":"Brain cavity shunt w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC1","description":"ICD-LGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD0","description":"ICD-BCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care level rationale doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6005F","description":"Care level rationale doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD1","description":"ICD-GFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place ndl musc/tis for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20555","description":"Place ndl musc/tis for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA07","description":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD0","description":"ICD-NJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93247","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc exten prosth addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34826","description":"Endovasc exten prosth addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB0","description":"ICD-KDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9804","description":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46948","description":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE0","description":"ICD-CFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF0","description":"ICD-MKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28088","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise urine flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50830","description":"Revise urine flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE225","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5226","description":"Mandibular part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF1","description":"ICD-BACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF1","description":"ICD-CFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB35","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay for calprotectin fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83993","description":"Assay for calprotectin fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB46","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Streptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3000","description":"Streptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21180","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF1","description":"ICD-OIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB0","description":"ICD-NINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9999","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF1","description":"ICD-EIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cool quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108T","description":"Cool quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC1","description":"ICD-NIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC1","description":"ICD-OKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD0","description":"ICD-HFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF1","description":"ICD-KCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2040","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA1","description":"ICD-NEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE0","description":"ICD-JDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA1","description":"ICD-LBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD0","description":"ICD-CIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB1","description":"ICD-ODXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90613","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","description":"CPT-90613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA1","description":"ICD-OIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27514","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microsurg epi sperm asp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4028","description":"Microsurg epi sperm asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB0","description":"ICD-CCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbo simultaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7181","description":"Electronic elbo simultaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Combination sit to stand sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0637","description":"Combination sit to stand sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2000","description":"Blinded administration of convulsive therapy procedure_ either electroconvulsive therapy (ect_ current covered gold standard) or magnetic seizure therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE0","description":"ICD-MIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9603","description":"Perc d-e cor stent ather br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","description":"HCPCS-Q5155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77615","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED1","description":"ICD-AGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB0","description":"ICD-GCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF1","description":"ICD-FILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB1","description":"ICD-OFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0096U","description":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2604","description":"Skin protect wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1025T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","description":"CPT-1025T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FUT2 GNOTYP FUT2 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0186U","description":"FUT2 GNOTYP FUT2 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC1","description":"ICD-MJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9716","description":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hdtrans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0248","description":"Hdtrans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Euglobulin lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85360","description":"Euglobulin lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33427","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB1","description":"ICD-JDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv push sngl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96409","description":"Chemo iv push sngl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33533","description":"Cabg arterial single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF0","description":"ICD-JCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thxp apheresis w/hdl delip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342T","description":"Thxp apheresis w/hdl delip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA1","description":"ICD-KANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0880T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA0","description":"ICD-IIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1747","description":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm device eval in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93288","description":"Pm device eval in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0932T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","description":"CPT-0932T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX33","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA0","description":"ICD-ADDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC0","description":"ICD-CHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA1","description":"ICD-KESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko double upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0902","description":"Ko double upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33735","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC1","description":"ICD-KIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA1","description":"ICD-OEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE1","description":"ICD-MDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB0","description":"ICD-IHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2213","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE1","description":"ICD-FGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF0","description":"ICD-KIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB1","description":"ICD-AADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj trimetrexate glucoronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3305","description":"Inj trimetrexate glucoronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE0","description":"ICD-OJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA1","description":"ICD-LHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB0","description":"ICD-KEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL22","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB0","description":"ICD-KDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF1","description":"ICD-ECBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC0","description":"ICD-GATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL05","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE1","description":"ICD-KCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA1","description":"ICD-BHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF0","description":"ICD-EDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27886","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0653T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD0","description":"ICD-BAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67902","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96574","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD1","description":"ICD-KABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skilled Nursing Facility Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4033","description":"Skilled Nursing Facility Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE0","description":"ICD-FEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle localization by xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77002","description":"Needle localization by xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC1","description":"ICD-MHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xii hageman","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85280","description":"Clot factor xii hageman","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB1","description":"ICD-NBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50236","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 10 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1642","description":"Inj heparin sodium per 10 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB1","description":"ICD-BHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heavyduty/wide commode chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0168","description":"Heavyduty/wide commode chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB31","description":"ICD-4CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB0","description":"ICD-OGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7642","description":"Glycopyrrolate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE0","description":"ICD-GDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral evaluation pt < 3yrs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0145","description":"Oral evaluation pt < 3yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF1","description":"ICD-CIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of magnesium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83735","description":"Assay of magnesium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB0","description":"ICD-BGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for localization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77011","description":"Ct scan for localization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/excise tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52355","description":"Cystouretero w/excise tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27536","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC0","description":"ICD-CCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1825","description":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB1","description":"ICD-NFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD1","description":"ICD-NLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81195","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","description":"CPT-81195","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavior management","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9920","description":"Behavior management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD0","description":"ICD-OKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC0","description":"ICD-DFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB0","description":"ICD-CBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE1","description":"ICD-BDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC1","description":"ICD-KHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonfamily hc train/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5116","description":"Nonfamily hc train/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC1","description":"ICD-NBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracranial uni/ltd study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93882","description":"Extracranial uni/ltd study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE0","description":"ICD-NGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA11","description":"ICD-1IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Furosemide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1940","description":"Furosemide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA0","description":"ICD-CCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB1","description":"ICD-GFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam pituitary saddle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70240","description":"X-ray exam pituitary saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Affinity1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4159","description":"Affinity1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA1","description":"ICD-JEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0705T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps w/fist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46262","description":"Remove in/ex hem grps w/fist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB1","description":"ICD-EGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Athletic train reeval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97006","description":"Athletic train reeval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD0","description":"ICD-KHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7333","description":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD1","description":"ICD-GCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF0","description":"ICD-KBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain biopsy w/ct/mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61751","description":"Brain biopsy w/ct/mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso r post pnl sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0630","description":"Lso r post pnl sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE1","description":"ICD-MLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE1","description":"ICD-NGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB0","description":"ICD-CFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99437","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016U","description":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE1","description":"ICD-KDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF1","description":"ICD-JHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0143","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4320","description":"Irrigation tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB15","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt dia retin msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9671","description":"Intend rpt dia retin msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8X","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA1","description":"ICD-GHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0062","description":"Audiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD1","description":"ICD-BGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 auto platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9571","description":"Indium in-111 auto platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD1","description":"ICD-GHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF1","description":"ICD-FGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in water/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6228","description":"Gauze <= 16 sq in water/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess susp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3344F","description":"Mammo assess susp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg >16 <=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6252","description":"Absorpt drg >16 <=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50290","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD113","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64857","description":"Repair arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rollabout chair with casters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1031","description":"Rollabout chair with casters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85044","description":"Manual reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB1","description":"ICD-NAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wcd device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93292","description":"Wcd device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE0","description":"ICD-FBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC0","description":"ICD-GCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3760F","description":"Pt w/dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0405","description":"HCPCS-C0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435U","description":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE0","description":"ICD-GEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinusitis intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9463","description":"Sinusitis intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC0","description":"ICD-ODBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21925","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc plan hybrid/stage proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9640","description":"Doc plan hybrid/stage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB0","description":"ICD-NLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant/graft palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26489","description":"Transplant/graft palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0841","description":"Pwc gp2 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA1","description":"ICD-JHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC36","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainable plastic pch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4375","description":"Drainable plastic pch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0663T","description":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0120U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD1","description":"ICD-IDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0798T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF1","description":"ICD-NAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED0","description":"ICD-BFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prednisolone oral per 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7510","description":"Prednisolone oral per 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD120","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA0","description":"ICD-DDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5B","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4282","description":"Cygnus dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE1","description":"ICD-BDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9063","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sio flex pelvisacral custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0622","description":"Sio flex pelvisacral custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF1","description":"ICD-IGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0311","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED0","description":"ICD-CCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10010","description":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE1","description":"ICD-OASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE0","description":"ICD-PESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF0","description":"ICD-ACIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB0","description":"ICD-MDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand les sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26111","description":"Exc hand les sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/giving drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95954","description":"Eeg monitoring/giving drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE0","description":"ICD-KBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA0","description":"ICD-NFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","description":"HCPCS-G0545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD1","description":"ICD-ACBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE0","description":"ICD-MEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eval laryngoscopy sense tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92615","description":"Eval laryngoscopy sense tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE0","description":"ICD-GCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA54","description":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB0","description":"ICD-EIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB201","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC1","description":"ICD-CASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF0","description":"ICD-ABBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gingival irrigation per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4921","description":"Gingival irrigation per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0201","description":"HCPCS-C0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA1","description":"ICD-AETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2A","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE0","description":"ICD-NHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED0","description":"ICD-KAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF1","description":"ICD-NEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av fistula revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36833","description":"Av fistula revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21453","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA0","description":"ICD-JHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF1","description":"ICD-BELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA1","description":"ICD-IACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF0","description":"ICD-MELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB0","description":"ICD-KCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9172","description":"HCPCS-C9172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA1","description":"ICD-BGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meg spontaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95965","description":"Meg spontaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD1","description":"ICD-PIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD0","description":"ICD-MLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED0","description":"ICD-OLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB0","description":"ICD-JICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB0","description":"ICD-HIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC1","description":"ICD-KHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC1","description":"ICD-OFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF0","description":"ICD-DHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD1","description":"ICD-GDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF1","description":"ICD-NBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26445","description":"Release hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC1","description":"ICD-NETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl beam other than prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4201F","description":"Extrnl beam other than prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE0","description":"ICD-LHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens gas impermeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2530","description":"Contact lens gas impermeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7500","description":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF1","description":"ICD-BIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED0","description":"ICD-FAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF1","description":"ICD-BAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE1","description":"ICD-CBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25145","description":"Remove forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC0","description":"ICD-EBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow lat ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24344","description":"Reconstruct elbow lat ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE1","description":"ICD-NFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA0","description":"ICD-CGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC0","description":"ICD-NLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0680","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD1","description":"ICD-OAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no statin med disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8817","description":"Doc reas no statin med disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD210","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD0","description":"ICD-KIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Particle agglut antbdy scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86403","description":"Particle agglut antbdy scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID1","description":"ICD-MKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96136","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7499","description":"Upper extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part maxil chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5740","description":"Denture reln part maxil chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9158","description":"Motor speech d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD1","description":"ICD-BIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC1","description":"ICD-KIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD1","description":"ICD-CIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC1","description":"ICD-KGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA1","description":"ICD-FHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile/panc endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74330","description":"X-ray bile/panc endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC0","description":"ICD-OBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB0","description":"ICD-IEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF1","description":"ICD-OHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0101","description":"CDT-D0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF0","description":"ICD-ODDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF0","description":"ICD-MKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC1","description":"ICD-IEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC1","description":"ICD-KBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5460","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage abdom abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49020","description":"Drainage abdom abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1087","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FUT1 GNOTYP FUT1 EXON 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0185U","description":"FUT1 GNOTYP FUT1 EXON 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE0","description":"ICD-AEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace high roll cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4060","description":"Replace high roll cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC1","description":"ICD-JITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE1","description":"ICD-GANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD1","description":"ICD-OETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4570","description":"Splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA1","description":"ICD-GGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complex body section x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76102","description":"Complex body section x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF1","description":"ICD-HHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB0","description":"ICD-AGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF0","description":"ICD-JCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF0","description":"ICD-ECBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc final","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3353","description":"Apexification/recalc final","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED1","description":"ICD-MKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED0","description":"ICD-KCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16375","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16375","description":"CPT-16375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manipulat palm cord post inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26341","description":"Manipulat palm cord post inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA0","description":"ICD-NDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE0","description":"ICD-MDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA0","description":"ICD-KEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC0","description":"ICD-CCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22840","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE1","description":"ICD-OLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7541","description":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63282","description":"Bx/exc idrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0C","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED1","description":"ICD-BCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mesentery lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44820","description":"Excision of mesentery lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC0","description":"ICD-OEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA31","description":"ICD-4AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA0","description":"ICD-ADAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1209","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB0","description":"ICD-OBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD0","description":"ICD-FAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22318","description":"Treat odontoid fx w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD1","description":"ICD-GFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE1","description":"ICD-GFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81200","description":"Aspa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD1","description":"ICD-GBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES314","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE1","description":"ICD-BEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aud rehab pre-ling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92630","description":"Aud rehab pre-ling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35666","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC0","description":"ICD-EDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0847T","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone intra implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7312","description":"Dexamethasone intra implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB0","description":"ICD-NIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove tunneled ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49422","description":"Remove tunneled ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81213","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenervation of abductor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2340","description":"Chemodenervation of abductor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF0","description":"ICD-LCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX12","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB1","description":"ICD-GAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34710","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB0","description":"ICD-NFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA0","description":"ICD-CIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA0","description":"ICD-NHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extension drainage tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4331","description":"Extension drainage tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC0","description":"ICD-GGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice_ inpatient hospital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5005","description":"Hospice_ inpatient hospital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF0","description":"ICD-OAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87484","description":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF1","description":"ICD-NGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj for sacroiliac jt anesth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0260","description":"Inj for sacroiliac jt anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caster fork replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2226","description":"Caster fork replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA0","description":"ICD-PKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE0","description":"ICD-NEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB1","description":"ICD-NLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA0","description":"ICD-GGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD1","description":"ICD-GEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement pressure alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1540","description":"Replacement pressure alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF1","description":"ICD-BHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5101","description":"HCPCS-A5101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34706","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE1","description":"ICD-PBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g ch add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15278","description":"Skn sub grft f/n/hf/g ch add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA106","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31294","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91309","description":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21263","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA1","description":"ICD-OLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE0","description":"ICD-KHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Torsion straight knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2380","description":"Torsion straight knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD0","description":"ICD-NBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB0","description":"ICD-FAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF0","description":"ICD-JFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC1","description":"ICD-IHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF1","description":"ICD-CFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0551U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0551U","description":"CPT-0551U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB0","description":"ICD-AGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9309","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9309","description":"HCPCS-C9309","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone replce graft first site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4263","description":"Bone replce graft first site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2006","description":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heat quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109T","description":"Heat quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71270","description":"Ct thorax w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA0","description":"ICD-DIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87164","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0603U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","description":"CPT-0603U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","description":"HCPCS-E0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD0","description":"ICD-OGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9276","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","description":"HCPCS-J9276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7515","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amphetamines 5 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80326","description":"Amphetamines 5 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE0","description":"ICD-OFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic sgd interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2351","description":"Electronic sgd interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0965T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","description":"CPT-0965T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB1","description":"ICD-BAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC1","description":"ICD-PBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB26","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC1","description":"ICD-CGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body pos current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8981","description":"Body pos current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95250","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14001","description":"Tis trnfr trunk 10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD1","description":"ICD-BCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA1","description":"ICD-PAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE1","description":"ICD-ABHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA0","description":"ICD-HGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64468","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","description":"CPT-64468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25500","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC1","description":"ICD-CGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB0","description":"ICD-OEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES235","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92517","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB1","description":"ICD-GIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57700","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Memory goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9169","description":"Memory goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE0","description":"ICD-OHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20910","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synvisc or synvisc-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7325","description":"Synvisc or synvisc-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC0","description":"ICD-DIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA1","description":"ICD-CGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant mid ear hearing pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5095","description":"Implant mid ear hearing pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA1","description":"ICD-OLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD1","description":"ICD-ODHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1701","description":"CDT-D1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids quan 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82139","description":"Amino acids quan 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA1","description":"ICD-OGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC0","description":"ICD-JDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI low field","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8042","description":"MRI low field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE0","description":"ICD-KEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF1","description":"ICD-BDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9594","description":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36511","description":"Apheresis wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC1","description":"ICD-PBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","description":"HCPCS-G0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA1","description":"ICD-JBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneum drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2381","description":"Pneum drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tmj excisn of joint membrane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7854","description":"Tmj excisn of joint membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE1","description":"ICD-FHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA0","description":"ICD-LDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1085","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9072","description":"Pathogen reduced platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd balloon dil esoph30 mm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43233","description":"Egd balloon dil esoph30 mm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB50","description":"Ultra High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Focusing on women_s health mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1366","description":"Focusing on women_s health mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD0","description":"ICD-CEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE0","description":"ICD-GFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB0","description":"ICD-IHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9899","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE1","description":"ICD-MFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE1","description":"ICD-BBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90935","description":"Hemodialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42509","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv >=10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4194F","description":"Pt rcv >=10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Angioscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35400","description":"Angioscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8648","description":"Fun stat score knee < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91010","description":"Esophagus motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transabdom amnioinfus w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59070","description":"Transabdom amnioinfus w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated platelet count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85049","description":"Automated platelet count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC1","description":"ICD-AHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38505","description":"Needle biopsy lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA1","description":"ICD-CDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA1","description":"ICD-MELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD1","description":"ICD-OCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB0","description":"ICD-JBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB1","description":"ICD-JBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE0","description":"ICD-FAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID0","description":"ICD-FBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF1","description":"ICD-FHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correct skin color 6.0 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11920","description":"Correct skin color 6.0 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA25","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC0","description":"ICD-OLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB1","description":"ICD-NAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB1","description":"ICD-EHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171U","description":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB0","description":"ICD-FGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA0","description":"ICD-CBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB0","description":"ICD-CBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD1","description":"ICD-MIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63277","description":"Bx/exc xdrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reopening of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49002","description":"Reopening of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1982","description":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB1","description":"ICD-BDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE0","description":"ICD-MHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB0","description":"ICD-EFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA0","description":"ICD-JFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA21","description":"ICD-1BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD0","description":"ICD-NFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB0","description":"ICD-OKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","description":"HCPCS-Q5161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD1","description":"ICD-ADLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF1","description":"ICD-GERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD0","description":"ICD-CIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC0","description":"ICD-OLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA1","description":"ICD-AGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC1","description":"ICD-IHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme cell activity ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82658","description":"Enzyme cell activity ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8839","description":"Sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of total testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84403","description":"Assay of total testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE0","description":"ICD-OGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31613","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal hemoglobin assay qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83033","description":"Fetal hemoglobin assay qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC0","description":"ICD-AEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA1","description":"ICD-EFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB1","description":"ICD-NGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9733","description":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA1","description":"ICD-EFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC0","description":"ICD-FEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82681","description":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD0","description":"ICD-GDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator jun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3207","description":"Hightop w/ supp/pronator jun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01782","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","description":"CPT-01782","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total electr w/ mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0265","description":"Hosp bed total electr w/ mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_yttrium-90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2616","description":"Brachytx_ non-str_yttrium-90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB03","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext pwrd shlder lock/unlock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6648","description":"Ext pwrd shlder lock/unlock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD1","description":"ICD-OFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX25","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE224","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0B","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald transmitter microphone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5290","description":"Ald transmitter microphone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD1","description":"ICD-NEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87561","description":"M.avium-intra dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE1","description":"ICD-BBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA0","description":"ICD-EBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","description":"HCPCS-A9612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parvovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86747","description":"Parvovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF1","description":"ICD-BEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ sock interscap-tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6690","description":"Frame typ sock interscap-tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9772","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8B","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE1","description":"ICD-BIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65275","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA113","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA0","description":"ICD-CHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB0","description":"ICD-NIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33999","description":"Cardiac surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Redo compl cardiac anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33622","description":"Redo compl cardiac anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Touch quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106T","description":"Touch quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0043U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6086","description":"Implant Supported Crown - Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23120","description":"Partial removal collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63281","description":"Bx/exc idrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vutrisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0225","description":"Injection_ vutrisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28645","description":"Repair toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post 3 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2393","description":"Post 3 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD1","description":"ICD-IGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE1","description":"ICD-OKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD0","description":"ICD-KHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63045","description":"Remove spine lamina 1 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31625","description":"Bronchoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gonadotropin hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80426","description":"Gonadotropin hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE1","description":"ICD-IGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject sinus tract for x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20501","description":"Inject sinus tract for x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE1","description":"ICD-NIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE1","description":"ICD-JAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m bicisate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9557","description":"Tc99m bicisate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE0","description":"ICD-CBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6031","description":"Benzodiazepines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2023","description":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preop asses 4 cataract surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3325F","description":"Preop asses 4 cataract surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prp i/hern init reduc >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49505","description":"Prp i/hern init reduc >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74022","description":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psori tool doc/no bnchmk met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9651","description":"Psori tool doc/no bnchmk met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA21","description":"ICD-2EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0C","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF1","description":"ICD-DASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB0","description":"ICD-CCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC0","description":"ICD-OBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arm supp att to wc rancho ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2627","description":"Arm supp att to wc rancho ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF1","description":"ICD-GIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","description":"HCPCS-M1462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4345","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","description":"HCPCS-Q4345","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB1","description":"ICD-FFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA0","description":"ICD-NBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00640","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","description":"CPT-00640","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB0","description":"ICD-KIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC1","description":"ICD-EGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE1","description":"ICD-DESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD1","description":"ICD-OLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Underarm crutch pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4635","description":"Underarm crutch pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C-1 esterase_ berinert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0597","description":"C-1 esterase_ berinert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml blast phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9125","description":"Onc dx cml blast phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC10","description":"High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth inpt pharm mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0459","description":"Telehealth inpt pharm mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27475","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA0","description":"ICD-KDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC0","description":"ICD-DFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD1","description":"ICD-DHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC1","description":"ICD-JGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX02","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF1","description":"ICD-OAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified preventive proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1999","description":"Unspecified preventive proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of finger(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73140","description":"X-ray exam of finger(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA0","description":"ICD-CAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA1","description":"ICD-KCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE0","description":"ICD-NFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC0","description":"ICD-GCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8666","description":"Fun stat score shdl not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF1","description":"ICD-GATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD1","description":"ICD-NIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE1","description":"ICD-GFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA25","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical trays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4550","description":"Surgical trays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA31","description":"ICD-1HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA0","description":"ICD-NFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC1","description":"ICD-BHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply upper l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8485","description":"Pros sock single ply upper l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko w adj flex/ext rotat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1846","description":"Ko w adj flex/ext rotat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE1","description":"ICD-ECUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64832","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37223","description":"Iliac revasc w/stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA0","description":"ICD-OJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD1","description":"ICD-CEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB0","description":"ICD-NDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attach ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65140","description":"Attach ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA0","description":"ICD-JGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA0","description":"ICD-GDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE0","description":"ICD-OKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB0","description":"ICD-BDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0577","description":"HCPCS-G0577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF1","description":"ICD-JBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1487","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","description":"HCPCS-M1487","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd us transmural injxn/mark","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43253","description":"Egd us transmural injxn/mark","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abduction bar jointed adjust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2300","description":"Abduction bar jointed adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0208","description":"Injection_ sodium thiosulfate_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD0","description":"ICD-JBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC1","description":"ICD-NKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD0","description":"ICD-BECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC0","description":"ICD-KFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-prxd rsk et al docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3018F","description":"Pre-prxd rsk et al docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD0","description":"ICD-CEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5146","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","description":"HCPCS-Q5146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB0","description":"ICD-CEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC1","description":"ICD-EGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83719","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81177","description":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES216","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Position back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2613","description":"Position back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF1","description":"ICD-OIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF0","description":"ICD-FGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC1","description":"ICD-EDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF0","description":"ICD-GCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA21","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE1","description":"ICD-OFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB11","description":"ICD-4GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5A","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5570","description":"Prep ak ischial direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","description":"HCPCS-L6037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC1","description":"ICD-BILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF0","description":"ICD-GFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD0","description":"ICD-ODKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE0","description":"ICD-KFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC0","description":"ICD-GCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement of drain pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48001","description":"Placement of drain pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD0","description":"ICD-GBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair ruptd popliteal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35152","description":"Repair ruptd popliteal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg >16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6204","description":"Composite drsg >16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC215","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC110","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD0","description":"ICD-KDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB0","description":"ICD-BFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA1","description":"ICD-OHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE0","description":"ICD-OASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0635U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0635U","description":"CPT-0635U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA0","description":"ICD-OKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC0","description":"ICD-IILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE0","description":"ICD-IGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD0","description":"ICD-PFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC1","description":"ICD-BHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy w/rf delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288T","description":"Anoscopy w/rf delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF0","description":"ICD-IGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE1","description":"ICD-EBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE0","description":"ICD-FDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID1","description":"ICD-JCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92612","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA0","description":"ICD-AFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36908","description":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE0","description":"ICD-OCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27502","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB1","description":"ICD-DGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF1","description":"ICD-GBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1501","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1501","description":"CDT-D1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA0","description":"ICD-KGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1121","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33767","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27752","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99215","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0490","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tonguemuscle_ controlled by hardware remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF1","description":"ICD-FBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD154","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below knee sus/seal sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5685","description":"Below knee sus/seal sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB0","description":"ICD-CBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF1","description":"ICD-EGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF1","description":"ICD-FAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90683","description":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE0","description":"ICD-CGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA1","description":"ICD-DARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncoprotein dcp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83951","description":"Oncoprotein dcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67312","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9050","description":"Injection_ emapalumab-lzsg_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6063","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB0","description":"ICD-AALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE0","description":"ICD-EBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD1","description":"ICD-GFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic prop tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2212","description":"Pneumatic prop tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB1","description":"ICD-BDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE0","description":"ICD-NLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32442","description":"Sleeve pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family homecare training 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5110","description":"Family homecare training 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB1","description":"ICD-KHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84702","description":"Chorionic gonadotropin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelv band/spread bar thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1640","description":"Pelv band/spread bar thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB0","description":"ICD-FCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB1","description":"ICD-OIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD0","description":"ICD-CGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Netupitant palonosetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8655","description":"Netupitant palonosetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Listeria monocytogenes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86723","description":"Listeria monocytogenes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD0","description":"ICD-NGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB0","description":"ICD-KCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2055","description":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF1","description":"ICD-GBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27638","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5615","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monosuspension arm/hand supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2630","description":"Monosuspension arm/hand supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE1","description":"ICD-EIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD1","description":"ICD-EEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA1","description":"ICD-BFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE0","description":"ICD-EAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0508","description":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA0","description":"ICD-CGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC1","description":"ICD-IAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Verteporfin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3396","description":"Verteporfin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC0","description":"ICD-OIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB0","description":"ICD-CEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE1","description":"ICD-NFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60520","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB0","description":"ICD-OFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0570T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB1","description":"ICD-LDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46744","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs spinal lesion addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63621","description":"Srs spinal lesion addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parainfluenza ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87279","description":"Parainfluenza ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD1","description":"ICD-CGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services given to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9740","description":"Hospice services given to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB0","description":"ICD-CGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32120","description":"Re-exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA1","description":"ICD-JHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fixed patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0640","description":"Fixed patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6245","description":"Bridge porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul revise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284T","description":"Periph field stimul revise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF1","description":"ICD-JETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23525","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD1","description":"ICD-NAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2A","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hgb >= 10 g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8976","description":"Hgb >= 10 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy rem totl cortex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32652","description":"Thoracoscopy rem totl cortex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43860","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abdominal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1270","description":"Abdominal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32505","description":"Wedge resect of lung initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF0","description":"ICD-OGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46740","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC0","description":"ICD-GCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX21","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0854","description":"Pwc gp 3 xhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF1","description":"ICD-LFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA1","description":"ICD-BGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular flange prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5934","description":"Mandibular flange prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD1","description":"ICD-GAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB1","description":"ICD-OKWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","description":"HCPCS-J9326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9936","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9936","description":"CDT-D9936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF0","description":"ICD-OGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32906","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reremove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25112","description":"Reremove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA0","description":"ICD-BEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8X","description":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB1","description":"ICD-NJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9748","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD1","description":"ICD-CETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC0","description":"ICD-KATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC0","description":"ICD-FIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB0","description":"ICD-JGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC1","description":"ICD-CGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA1","description":"ICD-BIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other specified case mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9012","description":"Other specified case mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj tst 3-4 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95908","description":"Nrv cndj tst 3-4 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF1","description":"ICD-LDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0619U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","description":"CPT-0619U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID1","description":"ICD-JAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3C","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA1","description":"ICD-GGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55707","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","description":"CPT-55707","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33259","description":"Ablate atria w/bypass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngrmnt glove-axilla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6506","description":"Cmprsburngrmnt glove-axilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE1","description":"ICD-KAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB0","description":"ICD-PJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE1","description":"ICD-MLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF0","description":"ICD-KCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC0","description":"ICD-OBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE0","description":"ICD-BACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47533","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gadobutrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9585","description":"Gadobutrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Path consult intraop addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88332","description":"Path consult intraop addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF1","description":"ICD-MHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reprogram cochlear implt 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92604","description":"Reprogram cochlear implt 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5172","description":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11106","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc no pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9251","description":"Doc no pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB1","description":"ICD-HCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC0","description":"ICD-GHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD1","description":"ICD-JAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD0","description":"ICD-CBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bridge base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6211","description":"Bridge base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF1","description":"ICD-DISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC0","description":"ICD-MHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX40","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF0","description":"ICD-MKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX45","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA0","description":"ICD-KHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC1","description":"ICD-BBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC1","description":"ICD-ADEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE0","description":"ICD-CDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sip and puff interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2325","description":"Sip and puff interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB0","description":"ICD-BGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1060T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1060T","description":"CPT-1060T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9137","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55110","description":"Explore scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA1","description":"ICD-LDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB0","description":"ICD-JDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD1","description":"ICD-NEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA1","description":"ICD-KAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine cord vsl thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63252","description":"Revise spine cord vsl thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6014","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD124","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6049","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6049","description":"CDT-D6049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB1","description":"ICD-MBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF1","description":"ICD-FANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 6/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72052","description":"X-ray exam neck spine 6/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC1","description":"ICD-OENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE0","description":"ICD-IBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF1","description":"ICD-CDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2310","description":"Lens sphc trifocal 4.25-7/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg>20min <=40min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2504","description":"Sgd prerec msg>20min <=40min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF1","description":"ICD-FDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD0","description":"ICD-GIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87809","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8X","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0715","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0715","description":"HCPCS-E0715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA1","description":"ICD-KDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD1","description":"ICD-AFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB0","description":"ICD-FBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6722","description":"Hook/hand_ hvy dty_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroplasty w/o v-band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43843","description":"Gastroplasty w/o v-band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC0","description":"ICD-JHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4054F","description":"Hemodialysis via catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD0","description":"ICD-BFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC0","description":"ICD-OBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Umbilical cord occlud w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59072","description":"Umbilical cord occlud w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB0","description":"ICD-DAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF0","description":"ICD-EIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD0","description":"ICD-OCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF1","description":"ICD-FIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE0","description":"ICD-FFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC254","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE1","description":"ICD-JFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA0","description":"ICD-MAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33688","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD1","description":"ICD-HIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit >30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12047","description":"Intmd rpr n-hf/genit >30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1140","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE0","description":"ICD-GGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB0","description":"ICD-CDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA115","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE0","description":"ICD-GHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0076","description":"Prolotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX44","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA0","description":"ICD-MCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC0","description":"ICD-AIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","description":"HCPCS-Q0155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin polyc mch sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5816","description":"Endo knee-shin polyc mch sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Presbyopia-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2788","description":"Presbyopia-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD221","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE0","description":"ICD-OIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC03","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF1","description":"ICD-LEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD1","description":"ICD-NKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF0","description":"ICD-OLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77067","description":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62303","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE0","description":"ICD-ODJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD1","description":"ICD-KEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE1","description":"ICD-MHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME0","description":"ICD-CEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95051","description":"Anesth vaginal endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA00","description":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE1","description":"ICD-AGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD1","description":"ICD-OIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE0","description":"ICD-KANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE1","description":"ICD-GHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylphenidate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80360","description":"Methylphenidate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUE0","description":"ICD-FEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD0","description":"ICD-OLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43848","description":"Revision gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC1","description":"ICD-MBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51940","description":"Correction of bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053U","description":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB0","description":"ICD-NILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB0","description":"ICD-FDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF0","description":"ICD-PAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC234","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458U","description":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Posaconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80187","description":"Posaconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC31","description":"ICD-3HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB206","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF0","description":"ICD-BCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arsenic trioxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9017","description":"Arsenic trioxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA0","description":"ICD-MDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Macroscopic exam arthropod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87168","description":"Macroscopic exam arthropod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE0","description":"ICD-GBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB0","description":"ICD-OABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcath stent cca w/eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37215","description":"Transcath stent cca w/eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29905","description":"Subtalar arthro w/exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD0","description":"ICD-OLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB0","description":"ICD-EIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME1","description":"ICD-CFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA11","description":"ICD-3BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE1","description":"ICD-KDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Jak2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81270","description":"Jak2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75980","description":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81460","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE0","description":"ICD-GGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92370","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lev 3 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0382","description":"Lev 3 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93575","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE1","description":"ICD-DISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA1","description":"ICD-LFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24066","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB1","description":"ICD-CDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA1","description":"ICD-OENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap close enterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44227","description":"Lap close enterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB0","description":"ICD-GBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA0","description":"ICD-AHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB43","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA1","description":"ICD-OKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB1","description":"ICD-NKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-cov surg proc_clin trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0293","description":"Non-cov surg proc_clin trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental suture wound to 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7911","description":"Dental suture wound to 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB1","description":"ICD-GEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF1","description":"ICD-NFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME1","description":"ICD-KIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ non sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1896","description":"Lead_ aicd_ non sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC1","description":"ICD-GBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF1","description":"ICD-NKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE1","description":"ICD-EHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3304","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD1","description":"ICD-BAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj estrogen conjugate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1410","description":"Inj estrogen conjugate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDE0","description":"ICD-BFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339T","description":"Trnscth renal symp denrv bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0632T","description":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1061T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1061T","description":"CPT-1061T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC0","description":"ICD-BGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND0","description":"ICD-NFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE0","description":"ICD-GHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0565T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25A","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE0","description":"ICD-MBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF0","description":"ICD-NBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA1","description":"ICD-HFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE1","description":"ICD-BFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD0","description":"ICD-GALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA1","description":"ICD-OHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB0","description":"ICD-NEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD0","description":"ICD-GHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External transmitter_ cgm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9277","description":"External transmitter_ cgm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calcium infusion test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82331","description":"Calcium infusion test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB1","description":"ICD-BEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE1","description":"ICD-GCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/ stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4081","description":"Enteral ng tubing w/ stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via av graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4053F","description":"Hemodialysis via av graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy nail unit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11755","description":"Biopsy nail unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","description":"CPT-98011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA23","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE1","description":"ICD-FCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL06","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9753","description":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67340","description":"Revise eye muscle add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA1","description":"ICD-CGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Zinc paste band w >=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6456","description":"Zinc paste band w >=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50065","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w>=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6444","description":"Conform band n/s w>=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chlorhexidine antisept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4248","description":"Chlorhexidine antisept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND1","description":"ICD-FIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE0","description":"ICD-OBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC02","description":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC1","description":"ICD-KGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE1","description":"ICD-IBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect neck tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21558","description":"Resect neck tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99334","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA1","description":"ICD-ECIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC53","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE0","description":"ICD-MECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD0","description":"ICD-GBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD124","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA1","description":"ICD-NEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA45","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urokinase 250_000 iu inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3365","description":"Urokinase 250_000 iu inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253U","description":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB0","description":"ICD-GBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC1","description":"ICD-CBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94619","description":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF1","description":"ICD-KCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug confirmation_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6058","description":"Drug confirmation_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD1","description":"ICD-KECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD0","description":"ICD-CFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9067","description":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84410","description":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA1","description":"ICD-GFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA0","description":"ICD-BEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED1","description":"ICD-JCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6100","description":"Removal of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB0","description":"ICD-GBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC0","description":"ICD-FFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA1","description":"ICD-EDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21045","description":"Extensive jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF0","description":"ICD-KIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0085","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF0","description":"ICD-MAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD1","description":"ICD-GISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45389","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF1","description":"ICD-GEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB1","description":"ICD-ADDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF0","description":"ICD-AIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB1","description":"ICD-JAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0599T","description":"Ncntc r-t fluor wnd img ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91125","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","description":"CPT-91125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB1","description":"ICD-BDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluor antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88346","description":"Immunofluor antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fld ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1238","description":"Fld ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD1","description":"ICD-CERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44143","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF1","description":"ICD-OFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abo rh blood typing docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3293F","description":"Abo rh blood typing docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA0","description":"ICD-GDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA0","description":"ICD-MIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014U","description":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34834","description":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL25","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bath tub wall rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0241","description":"Bath tub wall rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF1","description":"ICD-CHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92637","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","description":"CPT-92637","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9149","description":"Medical home level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355T","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF1","description":"ICD-CFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50555","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc system reas adv imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9537","description":"Doc system reas adv imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjust wrist ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1805","description":"Adjust wrist ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0530U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","description":"CPT-0530U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal up to 3mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0572","description":"Bupren/nal up to 3mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","description":"CPT-01630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC1","description":"ICD-GBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27830","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phentolaine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2760","description":"Phentolaine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB1","description":"ICD-CHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26010","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc order anti-plat or p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9609","description":"Doc order anti-plat or p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC144","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3425","description":"Root surgery molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Not disch home by day #2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8838","description":"Not disch home by day #2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of hydroxyapatite regeneration medicament - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2991","description":"Application of hydroxyapatite regeneration medicament - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF0","description":"ICD-GAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noncovered ambulance mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0888","description":"Noncovered ambulance mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","description":"HCPCS-M1416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88161","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aflibercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0178","description":"Aflibercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC135","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB0","description":"ICD-KFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Feeding aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5951","description":"Feeding aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB1","description":"ICD-OGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appli half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0669","description":"Seg pneumatic appli half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2002","description":"HCPCS-A2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99251","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC1","description":"ICD-OHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE1","description":"ICD-NCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE0","description":"ICD-HCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB1","description":"ICD-HHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393U","description":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1320","description":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB0","description":"ICD-MKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE0","description":"ICD-EFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB1","description":"ICD-JAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB1","description":"ICD-CCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27880","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE1","description":"ICD-IABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB0","description":"ICD-OJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF1","description":"ICD-EAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE0","description":"ICD-GHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB53","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mini-prop remote joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2312","description":"Mini-prop remote joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9783","description":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46922","description":"Excision of anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8429","description":"Gradient pressure wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiaxial ankle w dorsiflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5968","description":"Multiaxial ankle w dorsiflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE1","description":"ICD-KIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB1","description":"ICD-KENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB1","description":"ICD-BHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm order/admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4037F","description":"Influenza imm order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44100","description":"Biopsy of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable pack w/bowel syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0352","description":"Disposable pack w/bowel syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC0","description":"ICD-CAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quan levetiracetam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80177","description":"Drug scrn quan levetiracetam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test for blood flow in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15860","description":"Test for blood flow in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disability examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99456","description":"Disability examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE0","description":"ICD-FETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD0","description":"ICD-CGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA1","description":"ICD-ACMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7550","description":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81248","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82492","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0904","description":"HCPCS-A0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA0","description":"ICD-DIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF0","description":"ICD-JBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preparation for bladder xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51605","description":"Preparation for bladder xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1454","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forensic autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88040","description":"Forensic autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED1","description":"ICD-CEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cancer treatment plan change","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0354","description":"Cancer treatment plan change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF1","description":"ICD-EHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE1","description":"ICD-OJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE0","description":"ICD-NFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB1","description":"ICD-FDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA1","description":"ICD-BFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00934","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","description":"CPT-00934","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nortriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6037","description":"Nortriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor vii proconvertin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85230","description":"Clot factor vii proconvertin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","description":"HCPCS-J0162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA17","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient in hospice at any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9758","description":"Patient in hospice at any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/congen repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52400","description":"Cystouretero w/congen repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD1","description":"ICD-ICDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-non-el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0629","description":"Seat lift for pt furn-non-el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD0","description":"ICD-CBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD1","description":"ICD-KBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC1","description":"ICD-CDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77085","description":"Dxa bone density study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE0","description":"ICD-NIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX60","description":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","description":"HCPCS-J3376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND0","description":"ICD-CHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED1","description":"ICD-OLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB1","description":"ICD-DFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB1","description":"ICD-CEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Moisture exchanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4483","description":"Moisture exchanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC1","description":"ICD-CBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chd risk imt study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126T","description":"Chd risk imt study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB1","description":"ICD-GEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Head surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21499","description":"Head surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA1","description":"ICD-BHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC0","description":"ICD-NETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE1","description":"ICD-CCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC1","description":"ICD-GIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revas w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37225","description":"Fem/popl revas w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE0","description":"ICD-KEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD0","description":"ICD-CCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88373","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gadopiclenol_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9573","description":"Injection_ gadopiclenol_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lsh w/t/o uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58544","description":"Lsh w/t/o uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB1","description":"ICD-KGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB0","description":"ICD-CCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB1","description":"ICD-FGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA1","description":"ICD-OBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB1","description":"ICD-BFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX15","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF0","description":"ICD-MAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD0","description":"ICD-HCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB1","description":"ICD-IBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were deceased when the hu survey reached them","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1254","description":"Patients who were deceased when the hu survey reached them","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect tibia tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27645","description":"Resect tibia tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE0","description":"ICD-JDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB0","description":"ICD-MJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myelography l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72265","description":"Myelography l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC0","description":"ICD-CESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0048","description":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA0","description":"ICD-FEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB1","description":"ICD-NDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad glove med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8425","description":"Custom grad glove med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB0","description":"ICD-IHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF1","description":"ICD-DEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB1","description":"ICD-EGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF0","description":"ICD-BGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cdifficile testing performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3520F","description":"Cdifficile testing performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61686","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD1","description":"ICD-IACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46615","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA0","description":"ICD-KACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD217","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC0","description":"ICD-NGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE0","description":"ICD-FALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69637","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin d 25 hydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82306","description":"Vitamin d 25 hydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38226","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","description":"CPT-38226","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9083","description":"Injection_ amivantamab-vmjw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA0","description":"ICD-JITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert semi-rigid prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54400","description":"Insert semi-rigid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA1","description":"ICD-BDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0617U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","description":"CPT-0617U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15940","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycophenolate mofetil oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7517","description":"Mycophenolate mofetil oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD0","description":"ICD-EGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE1","description":"ICD-KGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF0","description":"ICD-NKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01430","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","description":"CPT-01430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE0","description":"ICD-NHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF0","description":"ICD-NDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD1","description":"ICD-NAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA0","description":"ICD-FDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc cath >90d for maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9265","description":"Doc cath >90d for maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62194","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE0","description":"ICD-KDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crisis interven waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2034","description":"Crisis interven waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28475","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1103","description":"CDT-D1103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25927","description":"Amputation of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4B","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME0","description":"ICD-IBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB0","description":"ICD-NJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41000","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88000","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA0","description":"ICD-OGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC0","description":"ICD-FGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breath hydrogen/methane test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91065","description":"Breath hydrogen/methane test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC0","description":"ICD-EGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC1","description":"ICD-GHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME1","description":"ICD-NKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB0","description":"ICD-MFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC0","description":"ICD-CCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA1","description":"ICD-HIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ehrlichia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86666","description":"Ehrlichia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av dialysis shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75791","description":"Av dialysis shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF0","description":"ICD-JGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26545","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD0","description":"ICD-KFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58150","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0838T","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB0","description":"ICD-OJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53505","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Novachor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4194","description":"Novachor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA1","description":"ICD-KEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16377","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16377","description":"CPT-16377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay blood carbon dioxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82374","description":"Assay blood carbon dioxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45116","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA1","description":"ICD-KBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB0","description":"ICD-IFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0526","description":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE1","description":"ICD-FHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD1","description":"ICD-LDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD0","description":"ICD-PCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complex lymphedema therapy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8950","description":"Complex lymphedema therapy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9053","description":"HCPCS-J9053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB0","description":"ICD-CFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2/co2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94681","description":"Exhaled air analysis o2/co2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0572T","description":"Insertion Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE0","description":"ICD-CHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE1","description":"ICD-KHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA204","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF0","description":"ICD-HCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE0","description":"ICD-BCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC1","description":"ICD-CGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9331","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0261","description":"Hosp bed semi-electr w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28306","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relieve cranial pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61345","description":"Relieve cranial pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC1","description":"ICD-EEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA1","description":"ICD-JBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA0","description":"ICD-OLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral antiplatelet therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4011F","description":"Oral antiplatelet therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj w/fluor eval cv device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36598","description":"Inj w/fluor eval cv device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fev<60% pred & no copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8925","description":"Fev<60% pred & no copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB23","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ deoxycholic acid_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0591","description":"Injection_ deoxycholic acid_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4524","description":"Adult size brief/diaper xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB0","description":"ICD-CHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA1","description":"ICD-CIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor 3 proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81509","description":"Ftl cgen abnor 3 proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Androstanediol glucuronide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82154","description":"Androstanediol glucuronide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test indirect titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86886","description":"Coombs test indirect titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB1","description":"ICD-NBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA31","description":"ICD-3GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8937","description":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE0","description":"ICD-CESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4148","description":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD0","description":"ICD-HBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD0","description":"ICD-GBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD0","description":"ICD-MFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8909","description":"Mra w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC0","description":"ICD-BIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA1","description":"ICD-FCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ca tx e-stim electr/transduc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4555","description":"Ca tx e-stim electr/transduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29855","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy single lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63042","description":"Laminotomy single lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB24","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photopheresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36522","description":"Photopheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB117","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB0","description":"ICD-KFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allogen_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4212","description":"Allogen_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB0","description":"ICD-NJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0816","description":"Pwc gp 1 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB0","description":"ICD-MKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213U","description":"RARE DS GEN DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80412","description":"Crh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF1","description":"ICD-GAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2069","description":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-corrosive finish","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2780","description":"Non-corrosive finish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA0","description":"ICD-MGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC0","description":"ICD-IBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phq-9 >9 during 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9511","description":"Phq-9 >9 during 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB0","description":"ICD-JDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF1","description":"ICD-CCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF1","description":"ICD-KADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC0","description":"ICD-KGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult companioncare per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5135","description":"Adult companioncare per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42409","description":"Drainage of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD0","description":"ICD-EGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE1","description":"ICD-NKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA1","description":"ICD-CBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA0","description":"ICD-LHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD251","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME1","description":"ICD-OBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES236","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB10","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342U","description":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD0","description":"ICD-NEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk pain & fxn assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1130F","description":"Bk pain & fxn assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trunk/thor pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0450","description":"Tlso flex trunk/thor pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8047","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB1","description":"ICD-NECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE1","description":"ICD-KBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE1","description":"ICD-OAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF0","description":"ICD-HFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB1","description":"ICD-CGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ofloxacin_ 400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0034","description":"Injection_ ofloxacin_ 400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD0","description":"ICD-OKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Subepithelial tissue graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4273","description":"Subepithelial tissue graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lifts tapered to one-ha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3332","description":"Shoe lifts tapered to one-ha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE0","description":"ICD-CDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE256","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA1","description":"ICD-GCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC1","description":"ICD-NLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB0","description":"ICD-IEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE0","description":"ICD-FBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE0","description":"ICD-CBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA1","description":"ICD-FEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE0","description":"ICD-ODYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove mastoid air cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69670","description":"Remove mastoid air cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA0","description":"ICD-OGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB0","description":"ICD-DFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB1","description":"ICD-KEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB13","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA1","description":"ICD-LEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","description":"HCPCS-A2030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE216","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chron care mgmt srvc 20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99490","description":"Chron care mgmt srvc 20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF1","description":"ICD-KFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medications not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9638","description":"At least two orders for the same high-risk medications not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0709T","description":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE105","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC0","description":"ICD-EHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB1","description":"ICD-NIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE0","description":"ICD-OKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB0","description":"ICD-OKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF1","description":"ICD-ABEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF0","description":"ICD-OITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB1","description":"ICD-IEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretreatment serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86978","description":"Rbc pretreatment serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC1","description":"ICD-NDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF1","description":"ICD-BBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC1","description":"ICD-EAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50955","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC1","description":"ICD-KGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD1","description":"ICD-FCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84154","description":"Assay of psa free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asp not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9437","description":"Asp not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC0","description":"ICD-GBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF1","description":"ICD-PESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD1","description":"ICD-EGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC1","description":"ICD-KGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36565","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8F","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE1","description":"ICD-AAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA1","description":"ICD-EGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sprvsd xrcz back pn >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4242F","description":"Sprvsd xrcz back pn >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE144","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB31","description":"ICD-3IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID0","description":"ICD-AIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laps rmvl vgl arry&pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314T","description":"Laps rmvl vgl arry&pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42961","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML2ND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112A","description":"ADM SARSCOV2 25MCG/0.25ML2ND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparotomy islet cell transp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0343","description":"Laparotomy islet cell transp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072A","description":"ADM SARSCV2 10MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","description":"HCPCS-Q4422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB1","description":"ICD-IFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Participant-Directed Community Supports","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1900","description":"Participant-Directed Community Supports","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE1","description":"ICD-CHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE1","description":"ICD-NGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC1","description":"ICD-NEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD1","description":"ICD-OCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85400","description":"Fibrinolytic plasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43191","description":"Esophagoscopy rigid trnso dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC1","description":"ICD-JHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"alloPLY_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4323","description":"alloPLY_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC0","description":"ICD-CGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cases in which an inhalational anesthetic is used only for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9955","description":"Cases in which an inhalational anesthetic is used only for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB105","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB1","description":"ICD-JDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA0","description":"ICD-OIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w/ supinator/pronator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3203","description":"Oxford w/ supinator/pronator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE1","description":"ICD-MKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48153","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB1","description":"ICD-NJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68810","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB1","description":"ICD-FAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL41","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","description":"HCPCS-J3379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace molded calf lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4050","description":"Replace molded calf lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc rehab svcs considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4079F","description":"Doc rehab svcs considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB0","description":"ICD-NLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor intestine/artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44721","description":"Prep donor intestine/artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open coronary endarterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33572","description":"Open coronary endarterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB1","description":"ICD-JBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32408","description":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma provocative tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92140","description":"Glaucoma provocative tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC1","description":"ICD-PFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","description":"HCPCS-J9382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC1","description":"ICD-MAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1247","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC0","description":"ICD-CAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA0","description":"ICD-CBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF0","description":"ICD-PDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus aug w bone/bone sup","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7951","description":"Sinus aug w bone/bone sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Potassium hydroxide preps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0112","description":"Potassium hydroxide preps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA104","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE0","description":"ICD-GDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF1","description":"ICD-OIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE1","description":"ICD-OAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0004","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of histamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83088","description":"Assay of histamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND1","description":"ICD-BBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB1","description":"ICD-AEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF1","description":"ICD-PJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB1","description":"ICD-BAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB0","description":"ICD-GAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infrared heating pad system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0221","description":"Infrared heating pad system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce earlobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69090","description":"Pierce earlobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Azithromycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0456","description":"Azithromycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF1","description":"ICD-OGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1025","description":"Ped compr care pkg_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med reas antibiotic pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8709","description":"Med reas antibiotic pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suprv interfac trnsport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99486","description":"Suprv interfac trnsport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interphalangeal joint spacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8658","description":"Interphalangeal joint spacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD0","description":"ICD-GHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA1","description":"ICD-ODHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67971","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assist living waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2031","description":"Assist living waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic wrist rotator any","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7259","description":"Electronic wrist rotator any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body pos goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8982","description":"Body pos goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC0","description":"ICD-OEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1813","description":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC1","description":"ICD-CERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA1","description":"ICD-HHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF0","description":"ICD-OIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construct vagina with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57292","description":"Construct vagina with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC1","description":"ICD-JBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27326","description":"Neurectomy popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA246","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69636","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD1","description":"ICD-FFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0495","description":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC0","description":"ICD-BCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm evaluation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89329","description":"Sperm evaluation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF1","description":"ICD-KIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bed board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0273","description":"Bed board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Food thickener oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4100","description":"Food thickener oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD1","description":"ICD-JCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5156","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","description":"HCPCS-Q5156","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC1","description":"ICD-LIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin full grft face/genit/hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15240","description":"Skin full grft face/genit/hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA1","description":"ICD-IGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF1","description":"ICD-LGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe nl duct w/balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68816","description":"Probe nl duct w/balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285T","description":"Periph field stimul analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 9-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88188","description":"Flowcytometry/read 9-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB1","description":"ICD-JIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC0","description":"ICD-BCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC1","description":"ICD-FACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB1","description":"ICD-GASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA31","description":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2042","description":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD1","description":"ICD-KARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5165","description":"HCPCS-Q5165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB0","description":"ICD-OFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA1","description":"ICD-GDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25274","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA1","description":"ICD-KFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visualization adjunct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9968","description":"Visualization adjunct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC1","description":"ICD-OARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA1","description":"ICD-HAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA0","description":"ICD-FGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41008","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF0","description":"ICD-JDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD0","description":"ICD-MDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Io radiation tx management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77469","description":"Io radiation tx management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone algrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20930","description":"Sp bone algrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB1","description":"ICD-GFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rho d immune globulin 50 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2788","description":"Rho d immune globulin 50 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker wheel attachment_pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0155","description":"Walker wheel attachment_pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Innovamatrix FS_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2013","description":"Innovamatrix FS_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8933","description":"Mra_ w/o&w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","description":"CPT-98012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE236","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81541","description":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF1","description":"ICD-IEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx gastro intub w/asp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43753","description":"Tx gastro intub w/asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quan mycophenolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80180","description":"Drug scrn quan mycophenolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA1","description":"ICD-KDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abd paracentesis w/imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49083","description":"Abd paracentesis w/imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB0","description":"ICD-PIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND1","description":"ICD-OCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA0","description":"ICD-CCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl smear w/diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85007","description":"Bl smear w/diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB1","description":"ICD-BIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE0","description":"ICD-OHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA0","description":"ICD-OAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE0","description":"ICD-FGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE1","description":"ICD-BGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93005","description":"Electrocardiogram tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF0","description":"ICD-CDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA0","description":"ICD-CAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD1","description":"ICD-GCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD0","description":"ICD-DHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB1","description":"ICD-CEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE0","description":"ICD-JCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible mic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87186","description":"Microbe susceptible mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42842","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis adsorp/reinfuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36515","description":"Apheresis adsorp/reinfuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB0","description":"ICD-IIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Site no lung or lung cx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9424","description":"Site no lung or lung cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428T","description":"Rmvl nstim apnea pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD130","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA0","description":"ICD-KDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB16","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB1","description":"ICD-GFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5B","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE0","description":"ICD-GFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE0","description":"ICD-JELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer not used w oxygen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7017","description":"Nebulizer not used w oxygen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE1","description":"ICD-OIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Integra drt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4105","description":"Integra drt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE0","description":"ICD-GDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54505","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert_ pneum wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2383","description":"Insert_ pneum wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device without flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7300","description":"Removal of temporary anchorage device without flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF1","description":"ICD-ODXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral infusion pump w/ ala","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9002","description":"Enteral infusion pump w/ ala","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC1","description":"ICD-FGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects >10.0 cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11954","description":"Tx contour defects >10.0 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67405","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0680U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680U","description":"CPT-0680U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC0","description":"ICD-OBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF1","description":"ICD-GGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF0","description":"ICD-DFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1169","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA1","description":"ICD-CIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65775","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0678","description":"Non-pneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB112","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Misc dialysis supplies noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4913","description":"Misc dialysis supplies noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier with flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4373","description":"Skin barrier with flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB0","description":"ICD-OHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transesoph doppl cardiac mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9157","description":"Transesoph doppl cardiac mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED0","description":"ICD-KFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flutamide 125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0175","description":"Flutamide 125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD0","description":"ICD-IDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB30","description":"Ultra High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA02","description":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC0","description":"ICD-KBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD1","description":"ICD-GDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE135","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9823","description":"Endometrial sampling or hysteroscopy with biopsy and results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Succinycholine chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0330","description":"Succinycholine chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB0","description":"ICD-GADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi prophylaxis for nsaid rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4017F","description":"Gi prophylaxis for nsaid rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC0","description":"ICD-OGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE0","description":"ICD-PCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA0","description":"ICD-KDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0144","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67917","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD1","description":"ICD-BICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC0","description":"ICD-OEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35281","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC0","description":"ICD-BFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 1 cc/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11950","description":"Tx contour defects 1 cc/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA0","description":"ICD-CCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1603","description":"HCPCS-A1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD1","description":"ICD-KAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24138","description":"Remove elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD1","description":"ICD-LAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 2/3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72082","description":"X-ray exam entire spi 2/3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD1","description":"ICD-NDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA1","description":"ICD-FDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML25","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17280","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97161","description":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asthma mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8646","description":"Asthma mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dopamine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1265","description":"Dopamine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD0","description":"ICD-PDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi wireless capsule measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91112","description":"Gi wireless capsule measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detach adjust armrest base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0017","description":"Detach adjust armrest base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55051","description":"Anesth sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00914","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","description":"CPT-00914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE0","description":"ICD-DIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA1","description":"ICD-BEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mdd mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3088F","description":"Mdd mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA0","description":"ICD-AEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2081","description":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA1","description":"ICD-FCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA0","description":"ICD-OCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9296","description":"Doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56051","description":"Anesth heart surg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0892","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA0","description":"ICD-CHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abrasion lesion single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15786","description":"Abrasion lesion single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC0","description":"ICD-FGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cell function assay w/stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86352","description":"Cell function assay w/stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine & cord thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63195","description":"Incise spine & cord thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB1","description":"ICD-FBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eravacycline_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0122","description":"Injection_ eravacycline_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Charger elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0495","description":"Charger elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB0","description":"ICD-OFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB1","description":"ICD-GEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shortening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26479","description":"Shortening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB1","description":"ICD-GGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC1","description":"ICD-NEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF0","description":"ICD-ADLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin ext jnts fld swg e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5726","description":"Knee-shin ext jnts fld swg e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE216","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF0","description":"ICD-MDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD230","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC0","description":"ICD-KINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC21","description":"ICD-4CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9141","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA0","description":"ICD-OJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart-vein defect(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33730","description":"Repair heart-vein defect(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB0","description":"ICD-NGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arbutamine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0395","description":"Arbutamine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Progressive lens per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2781","description":"Progressive lens per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0191","description":"Assessment of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE0","description":"ICD-AHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory eeg monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95950","description":"Ambulatory eeg monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC0","description":"ICD-BGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0498","description":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26235","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD0","description":"ICD-GDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23155","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0049","description":"Alcohol/drug screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28008","description":"Incision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE1","description":"ICD-GFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD1","description":"ICD-OIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE0","description":"ICD-OJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA1","description":"ICD-OBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31587","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD1","description":"ICD-KEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD1","description":"ICD-OBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB1","description":"ICD-CBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13132","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME0","description":"ICD-JGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ctrl dose inh drug deliv sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0730","description":"Ctrl dose inh drug deliv sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg art-vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33523","description":"Cabg art-vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lyse chest fibrin subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32562","description":"Lyse chest fibrin subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC1","description":"ICD-NCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC1","description":"ICD-JHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC1","description":"ICD-DFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1118","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD0","description":"ICD-NFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic pneumothorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32960","description":"Therapeutic pneumothorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96168","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharm dx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4641","description":"Radiopharm dx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spirom fev/fvc>/=70%/w/ocopd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3027F","description":"Spirom fev/fvc>/=70%/w/ocopd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE0","description":"ICD-CCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE0","description":"ICD-AEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87166","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE1","description":"ICD-JAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB0","description":"ICD-ODVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA0","description":"ICD-NLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Segmentectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32484","description":"Segmentectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB216","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"YT GNOTYP ACHE EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201U","description":"YT GNOTYP ACHE EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_strble_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1766","description":"Intro/sheath_strble_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0608T","description":"Rem mntr pulm flu mntr alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF0","description":"ICD-CILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48155","description":"Removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Add clasp to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5660","description":"Add clasp to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD0","description":"ICD-KGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF1","description":"ICD-GINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC1","description":"ICD-OCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA34","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE0","description":"ICD-KHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC11","description":"ICD-3IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC1","description":"ICD-BHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63287","description":"Bx/exc idrl imed lesn thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2071","description":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC0","description":"ICD-FEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE1","description":"ICD-MIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME0","description":"ICD-FBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB1","description":"ICD-NETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC1","description":"ICD-FAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB0","description":"ICD-MJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9984","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC1","description":"ICD-GHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC1","description":"ICD-EBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA1","description":"ICD-ABBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lamellar bdy fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83664","description":"Lamellar bdy fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ceftaroline fosamil inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0712","description":"Ceftaroline fosamil inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC1","description":"ICD-IHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD1","description":"ICD-CHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX42","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC1","description":"ICD-CHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA35","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF1","description":"ICD-KCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9813","description":"HCPCS-C9813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB1","description":"ICD-BCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD1","description":"ICD-MCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF0","description":"ICD-NKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE1","description":"ICD-GIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73719","description":"MRI lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA1","description":"ICD-CIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA0","description":"ICD-PJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE1","description":"ICD-JIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD0","description":"ICD-OEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","description":"HCPCS-M1397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE1","description":"ICD-GCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE1","description":"ICD-GHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA1","description":"ICD-ACLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA1","description":"ICD-GBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2172","description":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE0","description":"ICD-CDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD0","description":"ICD-DDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF0","description":"ICD-MACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE0","description":"ICD-JAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC1","description":"ICD-JBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE1","description":"ICD-ODWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC0","description":"ICD-BEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB1","description":"ICD-JCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB0","description":"ICD-GIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES324","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC1","description":"ICD-ABAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1001","description":"HCPCS-C1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9031","description":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD0","description":"ICD-CFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX22","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0970","description":"Tlso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE1","description":"ICD-FBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Waterjet prostate abltj cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421T","description":"Waterjet prostate abltj cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2066","description":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB0","description":"ICD-BFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC121","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv combination assay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0475","description":"Hiv combination assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD0","description":"ICD-NLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3085F","description":"Suicide risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95165","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4039","description":"Cast sup shrt leg ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB31","description":"ICD-4BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE0","description":"ICD-OKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC0","description":"ICD-BBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC21","description":"ICD-2HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sagittal rigid panel cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0636","description":"Lso sagittal rigid panel cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA1","description":"ICD-JHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28630","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB0","description":"ICD-LHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC0","description":"ICD-DCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF1","description":"ICD-EEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Statin not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9442","description":"Statin not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"JK GNOTYP SLC14A1 EXON 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0192U","description":"JK GNOTYP SLC14A1 EXON 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear matrix protein 22","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86386","description":"Nuclear matrix protein 22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB0","description":"ICD-IAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27680","description":"Release of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD1","description":"ICD-NAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70498","description":"Ct angiography neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90622","description":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB1","description":"ICD-KEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Totazoline hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2670","description":"Totazoline hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6007","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75964","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC1","description":"ICD-IGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB1","description":"ICD-PGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj beta interferon sq 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3028","description":"Inj beta interferon sq 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE1","description":"ICD-NLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94761","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD1","description":"ICD-FCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB1","description":"ICD-GCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF1","description":"ICD-MFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay clozapine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80159","description":"Drug assay clozapine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92083","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Other manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0009","description":"Other manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9593","description":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB1","description":"ICD-KBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0975T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","description":"CPT-0975T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC110","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF0","description":"ICD-NECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF1","description":"ICD-JDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID0","description":"ICD-BAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA1","description":"ICD-MFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91301","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0559U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","description":"CPT-0559U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >48 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6244","description":"Hydrogel drg >48 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mouth piece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4617","description":"Mouth piece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27216","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE0","description":"ICD-NEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE0","description":"ICD-OGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF1","description":"ICD-NJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE0","description":"ICD-ODQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE1","description":"ICD-JEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF0","description":"ICD-NGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF1","description":"ICD-JCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharm thx for op rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4005F","description":"Pharm thx for op rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9696","description":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE1","description":"ICD-FEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF1","description":"ICD-KCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2196","description":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1036","description":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8006","description":"HCPCS-C8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE1","description":"ICD-IBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0246","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE0","description":"ICD-PIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA1","description":"ICD-EGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB0","description":"ICD-OAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB0","description":"ICD-KESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0671","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0671","description":"HCPCS-G0671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB1","description":"ICD-GGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD0","description":"ICD-KEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric motility studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91020","description":"Gastric motility studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA1","description":"ICD-HHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB0","description":"ICD-BDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE1","description":"ICD-CEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD1","description":"ICD-JFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE0","description":"ICD-BCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33522","description":"Cabg artery-vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ft arch suprt premold longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3040","description":"Ft arch suprt premold longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose with potassium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5012","description":"5% dextrose with potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE1","description":"ICD-JIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88012","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF1","description":"ICD-PFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision/drain abscess extra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7521","description":"Incision/drain abscess extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB0","description":"ICD-JEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Omegaven_ 10 Grams Lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4187","description":"Omegaven_ 10 Grams Lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9108","description":"Onc dx pancreatic unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX22","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/density","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86972","description":"Rbc pretx incubatj w/density","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423U","description":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC1","description":"ICD-GIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63251","description":"Anesth removal of nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB0","description":"ICD-EFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD156","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1246","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB1","description":"ICD-MEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF1","description":"ICD-NDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD1","description":"ICD-LERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Battery pneum vad replacemnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0503","description":"Battery pneum vad replacemnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med service out of office","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99056","description":"Med service out of office","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB1","description":"ICD-NGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE0","description":"ICD-HFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF1","description":"ICD-NKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB1","description":"ICD-OIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aud osseo dev_ int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8690","description":"Aud osseo dev_ int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA0","description":"ICD-OIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sloughed off bone","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7550","description":"Removal of sloughed off bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collection of microorganisms","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0415","description":"Collection of microorganisms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1002","description":"CDT-D1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD1","description":"ICD-CEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mwc acc_ wheelchair brake","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2228","description":"Mwc acc_ wheelchair brake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB1","description":"ICD-BHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF0","description":"ICD-PHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB1","description":"ICD-HIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE0","description":"ICD-GFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0781T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC1","description":"ICD-IGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF0","description":"ICD-CABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE1","description":"ICD-FIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22103","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9690","description":"Patient receiving hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reoperation carotid add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35390","description":"Reoperation carotid add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Srs multisource","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77371","description":"Srs multisource","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7660","description":"Isoproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28070","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA1","description":"ICD-EDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA0","description":"ICD-EGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comb art/venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4755","description":"Comb art/venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD0","description":"ICD-IILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay acid phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84060","description":"Assay acid phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB0","description":"ICD-OEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioCoreTM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4227","description":"AmnioCoreTM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Arch suprt att to sho longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3070","description":"Arch suprt att to sho longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF0","description":"ICD-DHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult foster care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5140","description":"Adult foster care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20933","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF1","description":"ICD-KBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1083","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC220","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC1","description":"ICD-EGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE1","description":"ICD-MJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC0","description":"ICD-BFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of arsenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82175","description":"Assay of arsenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB0","description":"ICD-EEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobility cart pneum vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0502","description":"Mobility cart pneum vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA1","description":"ICD-EBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 5/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73523","description":"X-ray exam hips bi 5/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC1","description":"ICD-MCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA1","description":"ICD-AHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF1","description":"ICD-KDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rt heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93530","description":"Rt heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of cervical canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57800","description":"Dilation of cervical canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC1","description":"ICD-FIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA11","description":"ICD-3GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF1","description":"ICD-ADDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB1","description":"ICD-KDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC26","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6526","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE1","description":"ICD-NCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF1","description":"ICD-OFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy digital artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64820","description":"Sympathectomy digital artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD213","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB1","description":"ICD-CDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE0","description":"ICD-CDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8002","description":"Anterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx chron care w/o pt vsit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99487","description":"Cmplx chron care w/o pt vsit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA0","description":"ICD-NJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD0","description":"ICD-CFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01939","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","description":"CPT-01939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62164","description":"Remove brain tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn hearing aid bone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5040","description":"Body-worn hearing aid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC0","description":"ICD-AHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC1","description":"ICD-AHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90612","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","description":"CPT-90612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28570","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA1","description":"ICD-EIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF0","description":"ICD-JBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA1","description":"ICD-FGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB0","description":"ICD-CICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF0","description":"ICD-JHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/o bypass ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33255","description":"Ablate atria w/o bypass ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr epigastric hern blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49572","description":"Rpr epigastric hern blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD1","description":"ICD-NCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9153","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of suture from anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46754","description":"Removal of suture from anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD0","description":"ICD-JIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD0","description":"ICD-OHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA53","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - addressing appointment compliance barriers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9991","description":"Dental case management - addressing appointment compliance barriers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","description":"HCPCS-Q4391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54560","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ motixafortide_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2277","description":"Injection_ motixafortide_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF1","description":"ICD-NBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD1","description":"ICD-KCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF0","description":"ICD-BAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC0","description":"ICD-OIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF1","description":"ICD-BGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD204","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy chemodenervation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52287","description":"Cystoscopy chemodenervation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD0","description":"ICD-FEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC1","description":"ICD-GAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE0","description":"ICD-LDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429T","description":"Rmvl nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of methemalbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83857","description":"Assay of methemalbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","description":"CPT-01654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50976","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection intraop add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48400","description":"Injection intraop add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7683","description":"Triamcinolone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38520","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE0","description":"ICD-EGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28715","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of an implantable_ patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33284","description":"Removal of an implantable_ patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9019","description":"Platelets_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA0","description":"ICD-LDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC1","description":"ICD-EGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28735","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE0","description":"ICD-NHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND1","description":"ICD-JFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ethchlorvynol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6050","description":"Ethchlorvynol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0344U","description":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA0","description":"ICD-KHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22612","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4123","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36252","description":"Ins cath ren art 1st bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ferumoxytol_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0138","description":"Ferumoxytol_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA0","description":"ICD-IGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE0","description":"ICD-MBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preop anes or proxy b/4 surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9497","description":"Preop anes or proxy b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA0","description":"ICD-GDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC31","description":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2798","description":"Injection_ risperidone_ (perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plastic eye prosth custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2623","description":"Plastic eye prosth custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA1","description":"ICD-KCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2012","description":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA0","description":"ICD-NDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE0","description":"ICD-LDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB1","description":"ICD-CGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening fentanyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80354","description":"Drug screening fentanyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA0","description":"ICD-BEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA1","description":"ICD-FFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC1","description":"ICD-FCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68440","description":"Incise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36514","description":"Apheresis plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC41","description":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA0","description":"ICD-BFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1301","description":"HCPCS-B1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD0","description":"ICD-GIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9009","description":"Mccd_ risk adj_ level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Garamycin gentamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1580","description":"Garamycin gentamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shwr cov elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0501","description":"Shwr cov elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0740T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplj hematopoietic boost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38243","description":"Transplj hematopoietic boost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echograp trans r pros study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76873","description":"Echograp trans r pros study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF1","description":"ICD-EHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Throat surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42999","description":"Throat surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC06","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Taking statin or recd order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9664","description":"Taking statin or recd order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA0","description":"ICD-BCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44021","description":"Decompress small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous catheter anchor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5200","description":"Percutaneous catheter anchor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rails bed side half length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0305","description":"Rails bed side half length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis w/count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89310","description":"Semen analysis w/count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC1","description":"ICD-HFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0C","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninterest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0080","description":"Noninterest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove mastoid structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69505","description":"Remove mastoid structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0868","description":"Pwc gp 4 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hrdtry brst ca-rlatd dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81433","description":"Hrdtry brst ca-rlatd dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD1","description":"ICD-CEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25440","description":"Repair/graft wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35302","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDID0","description":"ICD-GDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","description":"CPT-01844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28238","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5112","description":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orphenadrine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2360","description":"Orphenadrine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE1","description":"ICD-BFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED0","description":"ICD-NCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA1","description":"ICD-CFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE0","description":"ICD-GGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA1","description":"ICD-NHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4185F","description":"Continuous ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE0","description":"ICD-CDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF0","description":"ICD-NLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled carbon dioxide test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94770","description":"Exhaled carbon dioxide test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rn telephone calls to dmp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0320","description":"Rn telephone calls to dmp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE0","description":"ICD-ABIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF0","description":"ICD-IEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27086","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28737","description":"Revision of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED1","description":"ICD-MEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF0","description":"ICD-PHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB0","description":"ICD-KEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8A","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE212","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA1","description":"ICD-KALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA0","description":"ICD-NDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF1","description":"ICD-KCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penile injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54235","description":"Penile injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB0","description":"ICD-GBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0501","description":"HCPCS-B0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA0","description":"ICD-NIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE1","description":"ICD-FGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image congen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75573","description":"Ct hrt w/3d image congen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9748","description":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD0","description":"ICD-JCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0622U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","description":"CPT-0622U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repeat thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60260","description":"Repeat thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC0","description":"ICD-HGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA0","description":"ICD-ABEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21602","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF1","description":"ICD-FFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA0","description":"ICD-GDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1137","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE1","description":"ICD-FFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC1","description":"ICD-NIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9329","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","description":"HCPCS-J9329","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB0","description":"ICD-JHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB1","description":"ICD-NCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal vol/count/mot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89320","description":"Semen anal vol/count/mot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interleukin-6 (Il-6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83529","description":"Interleukin-6 (Il-6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD0","description":"ICD-IHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza b ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87275","description":"Influenza b ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Tedizolid Phosphate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9446","description":"Injection_ Tedizolid Phosphate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE1","description":"ICD-CAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles monofocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92340","description":"Fit spectacles monofocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD1","description":"ICD-FFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF1","description":"ICD-OFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial foot exam pt lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0245","description":"Initial foot exam pt lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography dx w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74262","description":"Ct colonography dx w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9096","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pin finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26776","description":"Pin finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE1","description":"ICD-JFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA0","description":"ICD-LFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD0","description":"ICD-NCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anchor/screw bn/bn_tis/bn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1713","description":"Anchor/screw bn/bn_tis/bn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB0","description":"ICD-KDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0942T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","description":"CPT-0942T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF0","description":"ICD-JBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36660","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC0","description":"ICD-MCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methyldopate hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0210","description":"Methyldopate hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF0","description":"ICD-FDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF0","description":"ICD-CBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","description":"HCPCS-J0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA1","description":"ICD-GDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA1","description":"ICD-BEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64896","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11402","description":"Exc tr-ext b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1847","description":"Ko dbl upright w/air pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD0","description":"ICD-BGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot single axis ankle/foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5974","description":"Foot single axis ankle/foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postpartum care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503F","description":"Postpartum care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE1","description":"ICD-CGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC1","description":"ICD-HBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ballistocardiogram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3902","description":"Ballistocardiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ischm stroke symp lt3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1065F","description":"Ischm stroke symp lt3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of head of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23195","description":"Removal of head of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25391","description":"Lengthen radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig med check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8430","description":"Pt inelig med check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0087","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF0","description":"ICD-OEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7980","description":"Sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transtemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61595","description":"Transtemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD1","description":"ICD-DGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB0","description":"ICD-NBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr source elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0490","description":"Emr pwr source elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB11","description":"ICD-2CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF1","description":"ICD-MIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA1","description":"ICD-KGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE0","description":"ICD-CALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA0","description":"ICD-IIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB0","description":"ICD-CDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bath tub rail floor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0242","description":"Bath tub rail floor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA0","description":"ICD-OFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA0","description":"ICD-LESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF0","description":"ICD-OAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen tent excl croup/ped t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0455","description":"Oxygen tent excl croup/ped t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45398","description":"Colonoscopy w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9417","description":"No tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","description":"HCPCS-G0543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB1","description":"ICD-FFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo dual coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1895","description":"Lead_ aicd_ endo dual coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB1","description":"ICD-DGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC1","description":"ICD-OHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC0","description":"ICD-ODSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC1","description":"ICD-FEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewing single film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0270","description":"Dental bitewing single film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA1","description":"ICD-NFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA114","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC0","description":"ICD-BCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB0","description":"ICD-EACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NEURO MUSC DYS DMD SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218U","description":"NEURO MUSC DYS DMD SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87483","description":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE1","description":"ICD-CHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD0","description":"ICD-KEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6360","description":"Thoracic passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laminate labial veneer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2960","description":"Laminate labial veneer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD1","description":"ICD-MKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC1","description":"ICD-LFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB0","description":"ICD-BCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA0","description":"ICD-DGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF1","description":"ICD-NLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE0","description":"ICD-KIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunofix e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86334","description":"Immunofix e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC0","description":"ICD-OGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0697U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697U","description":"CPT-0697U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligation hemorrhoid w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249T","description":"Ligation hemorrhoid w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE1","description":"ICD-GCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ phenylephrine ketorolac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9447","description":"Inj_ phenylephrine ketorolac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF1","description":"ICD-GFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Withdrawal of arterial blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36600","description":"Withdrawal of arterial blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0801T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD1","description":"ICD-KDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient immunocompromised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1062","description":"Patient immunocompromised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel thomas with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3465","description":"Shoe heel thomas with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF1","description":"ICD-AFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD0","description":"ICD-FDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD1","description":"ICD-ODVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB31","description":"ICD-3GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB0","description":"ICD-KFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99214","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB1","description":"ICD-OJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA1","description":"ICD-LIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF0","description":"ICD-NGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF1","description":"ICD-NCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB1","description":"ICD-GEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thoracolmb 2/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72080","description":"X-ray exam thoracolmb 2/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB1","description":"ICD-OCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA0","description":"ICD-OJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB1","description":"ICD-GILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC0","description":"ICD-GARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilate tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68801","description":"Dilate tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD1","description":"ICD-GAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at e0733","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4541","description":"Monthly supplies for use of device coded at e0733","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC1","description":"ICD-LDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA0","description":"ICD-EHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD1","description":"ICD-CIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA0","description":"ICD-JFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15130","description":"Derm autograft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES104","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF0","description":"ICD-PGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak pelvic control belt light","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5692","description":"Ak pelvic control belt light","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD101","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9790","description":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC0","description":"ICD-FAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE1","description":"ICD-KDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA1","description":"ICD-KFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33641","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB144","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA1","description":"ICD-KEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucose test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82950","description":"Glucose test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 6-11 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87632","description":"Resp virus 6-11 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB1","description":"ICD-OHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal chrmoml aneuploidy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81420","description":"Fetal chrmoml aneuploidy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID0","description":"ICD-MCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC1","description":"ICD-KCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1319","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54380","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055U","description":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB0","description":"ICD-BHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esketamine_ nasal spray_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0013","description":"Esketamine_ nasal spray_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc supervision palliative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9054","description":"Onc supervision palliative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD1","description":"ICD-GIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX23","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE0","description":"ICD-FCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE1","description":"ICD-LGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83069","description":"Assay of urine hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC0","description":"ICD-FIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA1","description":"ICD-ACAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE0","description":"ICD-FDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6930","description":"Below elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical placement of craniofacial implant - extra oral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7993","description":"Surgical placement of craniofacial implant - extra oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF1","description":"ICD-FEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB0","description":"ICD-NGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME1","description":"ICD-BEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA1","description":"ICD-BIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA0","description":"ICD-PKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture screen only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87081","description":"Culture screen only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID0","description":"ICD-MKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of adp & amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82030","description":"Assay of adp & amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF1","description":"ICD-PAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD0","description":"ICD-OBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC0","description":"ICD-JDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplt allo hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38240","description":"Transplt allo hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of jaw nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64738","description":"Incision of jaw nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD1","description":"ICD-JDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC1","description":"ICD-JAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF1","description":"ICD-MFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF1","description":"ICD-NDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD1","description":"ICD-FHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA0","description":"ICD-ICDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0786T","description":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC1","description":"ICD-BIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF0","description":"ICD-OBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB0","description":"ICD-PKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69806","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"InnovaMatrix PD_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2023","description":"InnovaMatrix PD_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray for pancreas endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74329","description":"X-ray for pancreas endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB0","description":"ICD-HIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA1","description":"ICD-FHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD0","description":"ICD-OHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81189","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB0","description":"ICD-JDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC0","description":"ICD-DGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF1","description":"ICD-FHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resin one surface-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2330","description":"Resin one surface-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin tx mdd comm to tx clin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8959","description":"Clin tx mdd comm to tx clin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE0","description":"ICD-FEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q3h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9497","description":"Hit antibiotic q3h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15922","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE0","description":"ICD-HFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE1","description":"ICD-EHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF1","description":"ICD-CGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF0","description":"ICD-NAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC1","description":"ICD-JFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD1","description":"ICD-BIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maxillary part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5225","description":"Maxillary part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01230","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","description":"CPT-01230","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70390","description":"X-ray exam of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB1","description":"ICD-KDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441T","description":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB0","description":"ICD-CFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA21","description":"ICD-4JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Hot Entrée","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1759","description":"Home Delivered Meals-Hot Entrée","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF1","description":"ICD-JBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC0","description":"ICD-GFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC1","description":"ICD-HAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/revise male sling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53442","description":"Remove/revise male sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE1","description":"ICD-CIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96102","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND1","description":"ICD-KCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA21","description":"ICD-4GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40812","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8G","description":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38765","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2C","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33984","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF1","description":"ICD-OJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0598U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","description":"CPT-0598U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE0","description":"ICD-NKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD0","description":"ICD-JADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC0","description":"ICD-FBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enlargemnt of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2625","description":"Enlargemnt of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA213","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin tags add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11201","description":"Remove skin tags add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE0","description":"ICD-FDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 13.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7301","description":"Levonorgestrel iu 13.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CO GNOTYP AQP1 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0181U","description":"CO GNOTYP AQP1 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4035F","description":"Influenza imm rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reposition l ventric lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33226","description":"Reposition l ventric lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","description":"CPT-01474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA0","description":"ICD-OGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF0","description":"ICD-DDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE0","description":"ICD-AIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96121","description":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1313","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31231","description":"Nasal endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC0","description":"ICD-GBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA1","description":"ICD-ODLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","description":"CPT-92635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF0","description":"ICD-LDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA1","description":"ICD-IGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = II or III","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9831","description":"AJCC stage at breast cancer diagnosis = II or III","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1mg (Yondelis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9480","description":"Injection_ trabectedin_ 0.1mg (Yondelis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA0","description":"ICD-GFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75820","description":"Vein x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1227","description":"Wheelchair spec sz spec ht a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD0","description":"ICD-MKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66930","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA1","description":"ICD-BGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB0","description":"ICD-PHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0588U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","description":"CPT-0588U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA0","description":"ICD-GIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA0","description":"ICD-CCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA0","description":"ICD-JABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5167","description":"HCPCS-Q5167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC1","description":"ICD-KCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE1","description":"ICD-DIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9948","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC1","description":"ICD-NDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE0","description":"ICD-EILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso flex w/rigid stays cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0629","description":"Lso flex w/rigid stays cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB0","description":"ICD-OKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC1","description":"ICD-JBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC1","description":"ICD-FAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2105","description":"Spherocylinder 4.00d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diab manage trn per indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0108","description":"Diab manage trn per indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF1","description":"ICD-KGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB0","description":"ICD-AGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36500","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB0","description":"ICD-OKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC0","description":"ICD-BDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC1","description":"ICD-OJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE1","description":"ICD-OFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ferumoxytol_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0139","description":"Ferumoxytol_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB0","description":"ICD-AAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF1","description":"ICD-NGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med reason for no ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9196","description":"Med reason for no ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA1","description":"ICD-CHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell cnt/% docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3500F","description":"Cd4+cell cnt/% docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA0","description":"ICD-MJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig for ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8561","description":"Pt inelig for ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA1","description":"ICD-NGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE1","description":"ICD-GHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid uptake measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78012","description":"Thyroid uptake measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF0","description":"ICD-FEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","description":"HCPCS-E0469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cap bacterial assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012F","description":"Cap bacterial assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF0","description":"ICD-OKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4A","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0770T","description":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90686","description":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33419","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE0","description":"ICD-CAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Specimen fat stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89125","description":"Specimen fat stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430T","description":"Rmvl nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC1","description":"ICD-NBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID1","description":"ICD-IEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec hk-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94775","description":"Ped home apnea rec hk-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB0","description":"ICD-KISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC0","description":"ICD-KAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA1","description":"ICD-KDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87150","description":"Dna/rna amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC1","description":"ICD-GGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27187","description":"Reinforce hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB0","description":"ICD-GGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF1","description":"ICD-ADLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20561","description":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA1","description":"ICD-MCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA1","description":"ICD-OBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl >=3srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6611","description":"Onlay cst hgh nbl mtl >=3srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB0","description":"ICD-HFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE0","description":"ICD-IICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77523","description":"Proton trmt intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF1","description":"ICD-FCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4199","description":"Cygnus Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF0","description":"ICD-BALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA0","description":"ICD-BDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brentuximab vedotin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9042","description":"Brentuximab vedotin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA0","description":"ICD-PBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No start/rec antvir tx hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9499","description":"No start/rec antvir tx hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF1","description":"ICD-KEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD0","description":"ICD-OCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transthor cath for stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33621","description":"Transthor cath for stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE0","description":"ICD-NFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62220","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB0","description":"ICD-GFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration multiple fi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6905","description":"Hand restoration multiple fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE1","description":"ICD-KBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthr0 w/synovectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29863","description":"Hip arthr0 w/synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57010","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC1","description":"ICD-GBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF0","description":"ICD-FIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB0","description":"ICD-FDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA101","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD1","description":"ICD-GHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD1","description":"ICD-NFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD0","description":"ICD-FBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD0","description":"ICD-OJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE0","description":"ICD-BEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD0","description":"ICD-NAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1171","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB0","description":"ICD-OJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA0","description":"ICD-KDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore limb vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35860","description":"Explore limb vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foscarnet sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1455","description":"Foscarnet sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB0","description":"ICD-MGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1B","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE0","description":"ICD-MEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF0","description":"ICD-NHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB1","description":"ICD-ACUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6565","description":"Gradient compression gauntlet_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9294","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","description":"HCPCS-A9294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC34","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dil macular/fundus not perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8398","description":"Dil macular/fundus not perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2B","description":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch supp premold metat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3050","description":"Foot arch supp premold metat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of myoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83874","description":"Assay of myoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE234","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC1","description":"ICD-KEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD1","description":"ICD-NCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE141","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stress breaker","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6940","description":"Stress breaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE0","description":"ICD-DCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC0","description":"ICD-ODOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Td vacc no presv 7 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90714","description":"Td vacc no presv 7 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asympt carot/vrtbrbas sten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9005F","description":"Asympt carot/vrtbrbas sten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5D","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC1","description":"ICD-MIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC1","description":"ICD-OCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft brachial-brchl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35525","description":"Art byp grft brachial-brchl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21295","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB1","description":"ICD-HDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD0","description":"ICD-ADDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60100","description":"Biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD0","description":"ICD-JDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE0","description":"ICD-NFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1601","description":"HCPCS-A1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular blood flow measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198T","description":"Ocular blood flow measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD0","description":"ICD-KEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF1","description":"ICD-IDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Palonosetron hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2469","description":"Palonosetron hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cervical pneum trac equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0849","description":"Cervical pneum trac equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC0","description":"ICD-MHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED0","description":"ICD-NKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC251","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45385","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine incon plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509F","description":"Urine incon plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elevating whlchair leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0195","description":"Elevating whlchair leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 hd mult pow s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0886","description":"Pwc gp4 hd mult pow s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB1","description":"ICD-KAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA1","description":"ICD-CFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29435","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine not documented as administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1066","description":"Shingrix vaccine not documented as administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC1","description":"ICD-LEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73090","description":"X-ray exam of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF1","description":"ICD-ADAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9316","description":"Doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj tendon sheath/ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20550","description":"Inj tendon sheath/ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD0","description":"ICD-BGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methylenedioxyamphetamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80359","description":"Methylenedioxyamphetamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD0","description":"ICD-CBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF1","description":"ICD-NGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE1","description":"ICD-JILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF0","description":"ICD-JEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC0","description":"ICD-MGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE1","description":"ICD-FILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD0","description":"ICD-ICHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE1","description":"ICD-IGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD1","description":"ICD-FEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA1","description":"ICD-OIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE0","description":"ICD-NADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF1","description":"ICD-JCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig minidose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90385","description":"Rh ig minidose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77761","description":"Apply intrcav radiat simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD1","description":"ICD-CGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92987","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF0","description":"ICD-BENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uvl sys panel 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0693","description":"Uvl sys panel 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft carotid-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35508","description":"Art byp grft carotid-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24470","description":"Revision of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Posturography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92548","description":"Posturography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psysoc rehab svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2018","description":"Psysoc rehab svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC1","description":"ICD-BECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"End of life counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0257","description":"End of life counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC1","description":"ICD-FGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE0","description":"ICD-KBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 1or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80321","description":"Alcohols biomarkers 1or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test urine for porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84119","description":"Test urine for porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mold sckt ext knee shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5150","description":"Mold sckt ext knee shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE0","description":"ICD-NDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pump uninterrupted infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0455","description":"Pump uninterrupted infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA40","description":"Very High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF1","description":"ICD-PFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemfexy)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9304","description":"Injection_ pemetrexed (pemfexy)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD0","description":"ICD-OKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo fluid swing ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5724","description":"Knee-shin exo fluid swing ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA20","description":"Very High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown full base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6791","description":"Crown full base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB42","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC1","description":"ICD-NGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33280","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00702","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","description":"CPT-00702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD1","description":"ICD-CBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sympt show clin import drop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1451F","description":"Sympt show clin import drop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88016","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF0","description":"ICD-KBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB0","description":"ICD-CAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2125","description":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26434","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exam of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57452","description":"Exam of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oasis tri-layer wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4124","description":"Oasis tri-layer wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD1","description":"ICD-BEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE104","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext amb infusn pump insulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0784","description":"Ext amb infusn pump insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36566","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC0","description":"ICD-OBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC1","description":"ICD-KBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB1","description":"ICD-EDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3760","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of scapula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23190","description":"Partial removal of scapula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Airway inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94640","description":"Airway inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8B","description":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE155","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE1","description":"ICD-DFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8951","description":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy vag method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58145","description":"Myomectomy vag method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0504","description":"HCPCS-A0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA1","description":"ICD-OJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD1","description":"ICD-IGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA0","description":"ICD-GGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1214","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB1","description":"ICD-MJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF0","description":"ICD-NIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE1","description":"ICD-FBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5930","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5930","description":"CDT-D5930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE1","description":"ICD-MHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC1","description":"ICD-FGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","description":"CPT-64473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Somatropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2941","description":"Somatropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE0","description":"ICD-DIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF1","description":"ICD-BAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE1","description":"ICD-IFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fev <40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3040F","description":"Fev <40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxytocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2590","description":"Oxytocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB1","description":"ICD-CGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hx bld transf b/f 1992","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9449","description":"Hx bld transf b/f 1992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA1","description":"ICD-GAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC0","description":"ICD-EGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF0","description":"ICD-KCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE1","description":"ICD-ICEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC1","description":"ICD-EFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF0","description":"ICD-PAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA0","description":"ICD-NBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 5-8 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98962","description":"Self-mgmt educ/train 5-8 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE1","description":"ICD-LBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA0","description":"ICD-JEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB1","description":"ICD-KDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB0","description":"ICD-OFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA1","description":"ICD-MKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tactile breast img uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422T","description":"Tactile breast img uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61516","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE0","description":"ICD-OIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA0","description":"ICD-GGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE0","description":"ICD-OGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Promazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2950","description":"Promazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95700","description":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA0","description":"ICD-GHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA0","description":"ICD-HGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins device for rt guide open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49412","description":"Ins device for rt guide open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family/couple counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1006","description":"Family/couple counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC0","description":"ICD-OGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC1","description":"ICD-AICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE1","description":"ICD-PASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF1","description":"ICD-BCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Head control proximity switc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2330","description":"Head control proximity switc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA0","description":"ICD-CDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF0","description":"ICD-IIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF1","description":"ICD-CDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA1","description":"ICD-GCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC0","description":"ICD-CGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB1","description":"ICD-DHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigidlined cust fab two","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0486","description":"Tlso rigidlined cust fab two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","description":"HCPCS-M1426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF0","description":"ICD-GFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE0","description":"ICD-EAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8935","description":"Mra_ w/o dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB1","description":"ICD-FIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB0","description":"ICD-OLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF1","description":"ICD-JFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33268","description":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF0","description":"ICD-OCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj mepivacaine hcl/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0670","description":"Inj mepivacaine hcl/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC0","description":"ICD-AGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF1","description":"ICD-DHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0499U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","description":"CPT-0499U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close chest after drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32810","description":"Close chest after drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62115","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD1","description":"ICD-EFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB0","description":"ICD-GFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF1","description":"ICD-ECLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim implanted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0749","description":"Elec osteogen stim implanted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE1","description":"ICD-HERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26775","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF1","description":"ICD-KBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC0","description":"ICD-KCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA0","description":"ICD-CCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB1","description":"ICD-FHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA1","description":"ICD-PHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD234","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF0","description":"ICD-KCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28555","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB1","description":"ICD-BFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-spasmotic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9363","description":"Hit anti-spasmotic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9037","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB1","description":"ICD-AGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of intrastromal corneal ring segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099T","description":"Implantation of intrastromal corneal ring segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","description":"HCPCS-Q4392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE0","description":"ICD-FDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9184","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","description":"HCPCS-J9184","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME1","description":"ICD-CBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD1","description":"ICD-GGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0232","description":"HCPCS-M0232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD214","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NuDYN SL or NuDYN SLW_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4286","description":"NuDYN SL or NuDYN SLW_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE0","description":"ICD-BHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB1","description":"ICD-OAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64821","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA1","description":"ICD-CINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrn dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3759F","description":"Pt scrn dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA0","description":"ICD-CIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB0","description":"ICD-OAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC0","description":"ICD-KHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 600 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0240","description":"Injection_ casirivimab and imdevimab_ 600 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD1","description":"ICD-CIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65782","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF0","description":"ICD-FHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE0","description":"ICD-JCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF1","description":"ICD-ODPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81180","description":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB31","description":"ICD-3JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF0","description":"ICD-HARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA1","description":"ICD-NGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF1","description":"ICD-FGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC0","description":"ICD-NKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0802","description":"Pov group 1 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB0","description":"ICD-CBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA0","description":"ICD-FBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc slp ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0161","description":"Hhc slp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE0","description":"ICD-DFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC0","description":"ICD-MEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t3b-t4noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9079","description":"Onc dx prostate t3b-t4noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Counseling_ group_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9003","description":"Counseling_ group_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB1","description":"ICD-AATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD1","description":"ICD-JHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF1","description":"ICD-OACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF0","description":"ICD-BITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC0","description":"ICD-BEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB1","description":"ICD-EDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD1","description":"ICD-FAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA0","description":"ICD-FHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA1","description":"ICD-BFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0049U","description":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD1","description":"ICD-OBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE0","description":"ICD-KDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD1","description":"ICD-OAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36465","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35266","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC0","description":"ICD-GGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnicore pro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4298","description":"Amnicore pro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0896T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA0","description":"ICD-MBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport lodgng escrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0200","description":"Noner transport lodgng escrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD1","description":"ICD-BETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1639","description":"Dialysis scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC0","description":"ICD-PHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB1","description":"ICD-NAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9047","description":"Albumin (human)_ 25%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB0","description":"ICD-JCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c <100 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3048F","description":"Ldl-c <100 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA0","description":"ICD-OHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC1","description":"ICD-HESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF0","description":"ICD-BIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF0","description":"ICD-OBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB1","description":"ICD-MEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose intermed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77317","description":"Brachytx isodose intermed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93303","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70470","description":"Ct head/brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Derma-Gide_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4203","description":"Derma-Gide_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prior thyroid dise dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9553","description":"Prior thyroid dise dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF0","description":"ICD-OAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpnt stay radiolabeled item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9898","description":"Inpnt stay radiolabeled item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF0","description":"ICD-BEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3B","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB0","description":"ICD-NIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/insert drug implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11983","description":"Remove/insert drug implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11770","description":"Remove pilonidal cyst simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cilastatin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0743","description":"Cilastatin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD1","description":"ICD-HEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 1st stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0340","description":"Lifestyle mod 1st stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx multple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21347","description":"Opn tx nasomax fx multple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC0","description":"ICD-NBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB1","description":"ICD-IGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46040","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF1","description":"ICD-FFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE1","description":"ICD-NBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"L hrt cath trnsptl puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93462","description":"L hrt cath trnsptl puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB1","description":"ICD-KBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95926","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB0","description":"ICD-OKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0747T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB1","description":"ICD-NFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB33","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE0","description":"ICD-OJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1172","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF0","description":"ICD-JCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB1","description":"ICD-BEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF0","description":"ICD-BIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD0","description":"ICD-DBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1851","description":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE0","description":"ICD-BCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81166","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC1","description":"ICD-FGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB1","description":"ICD-JEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Outpatient_ ed_ or observation visits that result in an inpatient admission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2176","description":"Outpatient_ ed_ or observation visits that result in an inpatient admission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Report_ diabetes measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8485","description":"Report_ diabetes measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE1","description":"ICD-CEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE0","description":"ICD-BCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD0","description":"ICD-NFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB0","description":"ICD-LBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB1","description":"ICD-GDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2980","description":"Crown repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB0","description":"ICD-KICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF1","description":"ICD-BCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD0","description":"ICD-GFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA1","description":"ICD-JDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58672","description":"Laparoscopy fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forceps esoph biopsy done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3150F","description":"Forceps esoph biopsy done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA1","description":"ICD-PBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0166U","description":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA0","description":"ICD-FHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE0","description":"ICD-PHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81334","description":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio upr extrm w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73206","description":"Ct angio upr extrm w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB1","description":"ICD-JIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2508","description":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF1","description":"ICD-FEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63615","description":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External urinary catheter; non-disposable_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6591","description":"External urinary catheter; non-disposable_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No 1dose meni vac btwn 11&13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9415","description":"No 1dose meni vac btwn 11&13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ak flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5651","description":"Ak flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD0","description":"ICD-NADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE1","description":"ICD-OLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of kidney wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50500","description":"Repair of kidney wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE0","description":"ICD-FCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA03","description":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE1","description":"ICD-KGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB0","description":"ICD-FEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF1","description":"ICD-CIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC1","description":"ICD-OITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat eyelid by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68200","description":"Treat eyelid by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reimplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50380","description":"Reimplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC1","description":"ICD-FAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99219","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0621U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","description":"CPT-0621U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF0","description":"ICD-DIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx rad intra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25608","description":"Treat fx rad intra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0387","description":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME0","description":"ICD-OEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55060","description":"Repair of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6119","description":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE1","description":"ICD-KGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59514","description":"Cesarean delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB0","description":"ICD-KBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC0","description":"ICD-KAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB1","description":"ICD-NHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99417","description":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo partial colectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44204","description":"Laparo partial colectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","description":"CPT-00952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0600","description":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78104","description":"Bone marrow imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA0","description":"ICD-EFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE0","description":"ICD-FFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB0","description":"ICD-AEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA1","description":"ICD-PDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC141","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA21","description":"ICD-4AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thromboxane urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84431","description":"Thromboxane urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97761","description":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD1","description":"ICD-KIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD0","description":"ICD-IGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB11","description":"ICD-1DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped hospital bed semi/elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0329","description":"Ped hospital bed semi/elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB0","description":"ICD-DEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0914T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","description":"CPT-0914T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF1","description":"ICD-MBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB0","description":"ICD-HEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE0","description":"ICD-OAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29240","description":"Strapping of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93242","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA0","description":"ICD-LERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC1","description":"ICD-OALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0739","description":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39499","description":"Chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD0","description":"ICD-GGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0914","description":"Survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47420","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB1","description":"ICD-FDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC0","description":"ICD-CBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm autogrft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15110","description":"Epidrm autogrft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8H","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69740","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD0","description":"ICD-CBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9938","description":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2135","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB0","description":"ICD-ICAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC0","description":"ICD-BBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE1","description":"ICD-JCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA0","description":"ICD-HIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply rigid leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29445","description":"Apply rigid leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC0","description":"ICD-GCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB1","description":"ICD-DDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB0","description":"ICD-NEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME0","description":"ICD-KDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21610","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD1","description":"ICD-OHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA0","description":"ICD-IFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC0","description":"ICD-NJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC0","description":"ICD-NFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD0","description":"ICD-GHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE0","description":"ICD-FIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"40-75y w/type 1/2 w/ldl-c rs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9676","description":"40-75y w/type 1/2 w/ldl-c rs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28310","description":"Revision of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD0","description":"ICD-CHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sickle cell test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85660","description":"Rbc sickle cell test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9875","description":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF0","description":"ICD-CGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Internal Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4011","description":"Internal Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF1","description":"ICD-GAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4036","description":"Cast sup lngleg cylndr ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx hi enrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101T","description":"Extracorp shockwv tx hi enrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84144","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB1","description":"ICD-GGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA0","description":"ICD-HAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD1","description":"ICD-NLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33964","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD1","description":"ICD-CCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","description":"HCPCS-J2472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB0","description":"ICD-GIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459T","description":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC120","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC0","description":"ICD-EHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient And/Or Care Partner Decline Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0041","description":"Patient And/Or Care Partner Decline Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB0","description":"ICD-CHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD1","description":"ICD-NJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas inv disp sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1035","description":"Art pancreas inv disp sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Windowing of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29730","description":"Windowing of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE1","description":"ICD-MEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB1","description":"ICD-GBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0069","description":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitate each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9012","description":"Cryoprecipitate each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7609","description":"Albuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dxa results document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8399","description":"Pt w/dxa results document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC1","description":"ICD-KGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC1","description":"ICD-NLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC1","description":"ICD-FCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB0","description":"ICD-CDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE0","description":"ICD-OJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE0","description":"ICD-CGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC1","description":"ICD-BGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB0","description":"ICD-FHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq lamot/lam lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275T","description":"Perq lamot/lam lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF0","description":"ICD-DISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1502","description":"HCPCS-B1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optimizing Chronic Disease Management Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0056","description":"Optimizing Chronic Disease Management Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB11","description":"ICD-1HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC1","description":"ICD-OKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0057U","description":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF0","description":"ICD-DDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE1","description":"ICD-BBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2022","description":"Com wrap-around sv_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE1","description":"ICD-GDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC1","description":"ICD-NGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC0","description":"ICD-IDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dent therapeutic drug inject","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9610","description":"Dent therapeutic drug inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB1","description":"ICD-OJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC1","description":"ICD-ODEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3273F","description":"High risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9394","description":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB1","description":"ICD-CFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA0","description":"ICD-NBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA1","description":"ICD-BHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening pregabalin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80366","description":"Drug screening pregabalin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD0","description":"ICD-AFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB31","description":"ICD-4KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB0","description":"ICD-CGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB1","description":"ICD-PDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC1","description":"ICD-BCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2387","description":"Foam filled caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF0","description":"ICD-OIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41822","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD1","description":"ICD-OBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE0","description":"ICD-OAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69210","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0168U","description":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA0","description":"ICD-EFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB0","description":"ICD-ODWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF1","description":"ICD-HGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF0","description":"ICD-ADEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE0","description":"ICD-CANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gel cap app device for trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8515","description":"Gel cap app device for trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC226","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC1","description":"ICD-KCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC0","description":"ICD-ACDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC1","description":"ICD-OLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD0","description":"ICD-BGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9728","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA0","description":"ICD-KHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB1","description":"ICD-BHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35002","description":"Repair artery rupture neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB0","description":"ICD-OAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32601","description":"Thoracoscopy diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB0","description":"ICD-OLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD1","description":"ICD-DBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF1","description":"ICD-IHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE1","description":"ICD-ABTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1958","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1958","description":"HCPCS-J1958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF1","description":"ICD-ODOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Male sling procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53440","description":"Male sling procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD1","description":"ICD-OGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33238","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immune complex assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86332","description":"Immune complex assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-explore parathyroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60502","description":"Re-explore parathyroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt has symp&signs neuropathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3753F","description":"Pt has symp&signs neuropathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pralidoxime chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2730","description":"Pralidoxime chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE1","description":"ICD-OLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0797T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42320","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay infectious agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86317","description":"Immunoassay infectious agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allergy immunology services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95199","description":"Allergy immunology services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eardrum revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69450","description":"Eardrum revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","description":"HCPCS-J0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE0","description":"ICD-NBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1163","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC0","description":"ICD-MIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tte w/doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93306","description":"Tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE0","description":"ICD-IIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Referred for an av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4051F","description":"Referred for an av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF1","description":"ICD-EBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74430","description":"Contrast x-ray bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61582","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 2 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90633","description":"Hepa vacc ped/adol 2 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap radical hyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58548","description":"Lap radical hyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electron microscopy diagnost","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0481","description":"Electron microscopy diagnost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of facial bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21026","description":"Excision of facial bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repr elbow lat ligmnt w/tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24343","description":"Repr elbow lat ligmnt w/tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE1","description":"ICD-BHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD0","description":"ICD-OKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA1","description":"ICD-BDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35663","description":"Art byp ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA31","description":"ICD-1FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF1","description":"ICD-GCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy treat blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31641","description":"Bronchoscopy treat blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF0","description":"ICD-JATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate crtd sns dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272T","description":"Interrogate crtd sns dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB124","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID1","description":"ICD-MLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1603","description":"HCPCS-C1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15951","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA0","description":"ICD-NEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF0","description":"ICD-IHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE1","description":"ICD-OGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0061U","description":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC1","description":"ICD-CAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lang express current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9162","description":"Lang express current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","description":"CPT-01832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0700T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB0","description":"ICD-KACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73720","description":"MRI lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD244","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE0","description":"ICD-CENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Audit/dast over 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99409","description":"Audit/dast over 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil one surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2410","description":"Dental gold foil one surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC1","description":"ICD-KDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD0","description":"ICD-GFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98979","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","description":"CPT-98979","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ver doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8565","description":"Ver doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC1","description":"ICD-DCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID1","description":"ICD-NHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB1","description":"ICD-FAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural c/t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64479","description":"Inj foramen epidural c/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA1","description":"ICD-JHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE1","description":"ICD-FDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD0","description":"ICD-OLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67808","description":"Remove eyelid lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0009","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC1","description":"ICD-DBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA0","description":"ICD-DAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1345","description":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB0","description":"ICD-KCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27442","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC1","description":"ICD-PFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17108","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF0","description":"ICD-OCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB0","description":"ICD-OFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD0","description":"ICD-OICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30905","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD1","description":"ICD-CGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC0","description":"ICD-LGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB0","description":"ICD-KFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF0","description":"ICD-BAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 4mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0464","description":"Tlso 4mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urine reagent strips/tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4250","description":"Urine reagent strips/tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB1","description":"ICD-CDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","description":"HCPCS-J7173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1092","description":"Wheelchair wide w/ leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc ob care/deliver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59898","description":"Laparo proc ob care/deliver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0503","description":"CDT-D0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE1","description":"ICD-ICCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin chromotography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83021","description":"Hemoglobin chromotography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0480","description":"Tlso rigid plastic custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9811","description":"Patient did not achieve a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin peel therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17360","description":"Skin peel therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA1","description":"ICD-JCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94774","description":"Ped home apnea rec compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF1","description":"ICD-GIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE1","description":"ICD-OCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA11","description":"ICD-1KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5001","description":"HCPCS-A5001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC0","description":"ICD-NDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD0","description":"ICD-HASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC160","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse upper gi structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47721","description":"Fuse upper gi structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA0","description":"ICD-FCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA24","description":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0707T","description":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42330","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA0","description":"ICD-LFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD0","description":"ICD-CCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD0","description":"ICD-PCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35246","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2361","description":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit inj interferon diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9559","description":"Hit inj interferon diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA1","description":"ICD-GBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01622","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","description":"CPT-01622","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epieffect_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4278","description":"Epieffect_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N-et; stretcher van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2005","description":"N-et; stretcher van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA0","description":"ICD-OGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE0","description":"ICD-HGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC40","description":"High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair bearings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2210","description":"Wheelchair bearings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD0","description":"ICD-PGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD0","description":"ICD-GEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND1","description":"ICD-OIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC114","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB1","description":"ICD-OEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE1","description":"ICD-KAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC1","description":"ICD-ICEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hpv combo assay ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0476","description":"Hpv combo assay ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3B","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automatic ext defibrillator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0617","description":"Automatic ext defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC0","description":"ICD-GCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA0","description":"ICD-BAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 9 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP09","description":"Auto.test pane pricing code_ 9 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD1","description":"ICD-HGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB1","description":"ICD-NCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose in lactated ringer_s_ 1000 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5011","description":"5% dextrose in lactated ringer_s_ 1000 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE0","description":"ICD-NCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX02","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA1","description":"ICD-AGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99223","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8B","description":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB0","description":"ICD-FFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE114","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1729","description":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2542","description":"Dental onlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4011","description":"Cast sup sht arm ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20100","description":"Explore wound neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE1","description":"ICD-BATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0660U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0660U","description":"CPT-0660U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255U","description":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9855","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97710","description":"","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC1","description":"ICD-ACHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84300","description":"Assay of urine sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1330","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ob us detailed addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76812","description":"Ob us detailed addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Als 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0426","description":"Als 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD0","description":"ICD-FDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF0","description":"ICD-JHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate epi sz 14 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381T","description":"Ext h rate epi sz 14 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputee adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0959","description":"Amputee adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF0","description":"ICD-OCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE0","description":"ICD-ODCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF1","description":"ICD-FAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med pt reas no hcc scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9456","description":"Doc med pt reas no hcc scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":">85y scope othr rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9661","description":">85y scope othr rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD1","description":"ICD-JDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0549U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","description":"CPT-0549U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB1","description":"ICD-DFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumophilia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87278","description":"Legion pneumophilia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8C","description":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA1","description":"ICD-CDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE0","description":"ICD-NHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67412","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA1","description":"ICD-BIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA1","description":"ICD-KDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD1","description":"ICD-NCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81405","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1280","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF1","description":"ICD-OJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC0","description":"ICD-NHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC0","description":"ICD-LAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC1","description":"ICD-JIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA1","description":"ICD-AGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE0","description":"ICD-OIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA0","description":"ICD-ODMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE0","description":"ICD-OILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5170","description":"HCPCS-Q5170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA1","description":"ICD-OGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE0","description":"ICD-MCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close kidney-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50520","description":"Close kidney-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj vocal cord bulking agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8607","description":"Inj vocal cord bulking agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA1","description":"ICD-MGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD0","description":"ICD-ECHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD0","description":"ICD-EIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94680","description":"Exhaled air analysis o2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB1","description":"ICD-EDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA0","description":"ICD-OHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC1","description":"ICD-KBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81312","description":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF1","description":"ICD-OKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE1","description":"ICD-FHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28210","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA1","description":"ICD-KIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC1","description":"ICD-FAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62322","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of rbc pg6d enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84085","description":"Assay of rbc pg6d enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC1","description":"ICD-CCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF1","description":"ICD-AFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD1","description":"ICD-CCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF0","description":"ICD-GFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD1","description":"ICD-JGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED0","description":"ICD-GCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros pt in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8507","description":"Trach-esoph voice pros pt in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59409","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98005","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","description":"CPT-98005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC11","description":"ICD-2AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA0","description":"ICD-NKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transplant ureter to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50860","description":"Transplant ureter to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA1","description":"ICD-FAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE0","description":"ICD-OKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6530","description":"Compression stocking bk18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC60","description":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE1","description":"ICD-BIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB1","description":"ICD-OBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD1","description":"ICD-NALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD0","description":"ICD-OERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6523","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35351","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC0","description":"ICD-ADLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB0","description":"ICD-JIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61522","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE1","description":"ICD-MJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC1","description":"ICD-NBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA0","description":"ICD-KHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC1","description":"ICD-HDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75600","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB0","description":"ICD-GGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64584","description":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF1","description":"ICD-JAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0729T","description":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - care coordination","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9992","description":"Dental case management - care coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD1","description":"ICD-NDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50940","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF1","description":"ICD-BEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB1","description":"ICD-CHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microdissection laser","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88380","description":"Microdissection laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED0","description":"ICD-NIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF1","description":"ICD-CGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC1","description":"ICD-FFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL41","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8993","description":"Sub pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC1","description":"ICD-GCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/o kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74240","description":"X-ray upper gi delay w/o kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC0","description":"ICD-KDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA0","description":"ICD-BGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA1","description":"ICD-AFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE1","description":"ICD-KBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shlder disart int lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6300","description":"Shlder disart int lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.25-7/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2307","description":"Lens sphcy trifocal 4.25-7/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27335","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","description":"CPT-01656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78202","description":"Liver imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC0","description":"ICD-IFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC1","description":"ICD-NCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD0","description":"ICD-BAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0766T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop oct breast cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353T","description":"Intraop oct breast cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7354","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF0","description":"ICD-LFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA1","description":"ICD-NFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1252","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX55","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1056T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1056T","description":"CPT-1056T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi/renal risk assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1008F","description":"Gi/renal risk assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative assay drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80299","description":"Quantitative assay drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lungcx bx rpt docs class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9418","description":"Lungcx bx rpt docs class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD0","description":"ICD-KCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA0","description":"ICD-NJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE1","description":"ICD-IIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE0","description":"ICD-NAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB0","description":"ICD-JBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF1","description":"ICD-IIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC0","description":"ICD-KEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB0","description":"ICD-FCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB1","description":"ICD-NLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbow hosmer swit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7170","description":"Electronic elbow hosmer swit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB0","description":"ICD-JCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37780","description":"Revision of leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX11","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC0","description":"ICD-NKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grp b strep screening docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3294F","description":"Grp b strep screening docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF0","description":"ICD-MHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88106","description":"Cytopath fl nongyn filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5110","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67040","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC1","description":"ICD-MCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB0","description":"ICD-NJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD1","description":"ICD-KHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69635","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF1","description":"ICD-JDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC1","description":"ICD-IAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73120","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD1","description":"ICD-ACCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1073","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF1","description":"ICD-NGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hook vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6707","description":"Term dev mech hook vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB0","description":"ICD-OBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27690","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9803","description":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE0","description":"ICD-BEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC0","description":"ICD-NLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE0","description":"ICD-JIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cyanide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82600","description":"Assay of cyanide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA0","description":"ICD-FAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA1","description":"ICD-JIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8G","description":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE0","description":"ICD-GGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB0","description":"ICD-GCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24330","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas on statin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9507","description":"Doc reas on statin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","description":"HCPCS-J2151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA0","description":"ICD-NLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD0","description":"ICD-OBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dias bp > or = 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8755","description":"Dias bp > or = 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic shoe add rub insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3510","description":"Orthopedic shoe add rub insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31297","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 2 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2620","description":"Inlay porcelain/ceramic 2 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47700","description":"Exploration of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE0","description":"ICD-MDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aud osseo dev_ abutment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8693","description":"Aud osseo dev_ abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC31","description":"ICD-1CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91113","description":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC1","description":"ICD-JGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE1","description":"ICD-JHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kyphosis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1020","description":"Kyphosis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection of contrast for knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27370","description":"Injection of contrast for knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF1","description":"ICD-BHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF0","description":"ICD-CHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Personal care ser per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1019","description":"Personal care ser per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD0","description":"ICD-IIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA0","description":"ICD-IBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE0","description":"ICD-JAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7760","description":"Clsd red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8924","description":"2d tte w or w/o fol w/con_fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA0","description":"ICD-JDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occult bld feces 1-3 tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82272","description":"Occult bld feces 1-3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pin radioulnar dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25671","description":"Pin radioulnar dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE0","description":"ICD-NIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA1","description":"ICD-ABDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC1","description":"ICD-EFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE0","description":"ICD-MFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND1","description":"ICD-NGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5130","description":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE1","description":"ICD-CFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA0","description":"ICD-GGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37290","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","description":"CPT-37290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA0","description":"ICD-KCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood platelet aggregation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85576","description":"Blood platelet aggregation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF1","description":"ICD-GIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX44","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67516","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE1","description":"ICD-EIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC0","description":"ICD-OHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB0","description":"ICD-ODLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE1","description":"ICD-CENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dxa no results doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8400","description":"Pt w/dxa no results doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC1","description":"ICD-OBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE0","description":"ICD-OGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED0","description":"ICD-OCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0185","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND0","description":"ICD-GIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27252","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA0","description":"ICD-MDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD111","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic shoe w/off set heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5506","description":"Diabetic shoe w/off set heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD1","description":"ICD-DFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB15","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD0","description":"ICD-IALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD1","description":"ICD-OBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext at dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9069","description":"Onc dx sclc/nsclc ext at dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD1","description":"ICD-BHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA1","description":"ICD-BFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE0","description":"ICD-NDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA1","description":"ICD-ECAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8D","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC1","description":"ICD-CDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB1","description":"ICD-GFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA0","description":"ICD-OLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE1","description":"ICD-NJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl cushions for jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1701","description":"Repl cushions for jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD0","description":"ICD-AGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Placement of seton","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46020","description":"Placement of seton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30901","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA0","description":"ICD-KEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB0","description":"ICD-CCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73020","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB0","description":"ICD-IACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA0","description":"ICD-MLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA1","description":"ICD-CIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66999","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA1","description":"ICD-PJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE0","description":"ICD-ICIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit interim cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5502","description":"Hit interim cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30540","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facial nerve function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92516","description":"Facial nerve function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC1","description":"ICD-BCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9471","description":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB1","description":"ICD-CAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia infuse each addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96423","description":"Chemo ia infuse each addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81289","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF0","description":"ICD-KHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB1","description":"ICD-CIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application long leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29505","description":"Application long leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC1","description":"ICD-EFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF0","description":"ICD-KIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE0","description":"ICD-NLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0181","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF1","description":"ICD-KAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB0","description":"ICD-IBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sio panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0624","description":"Sio panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"GYPA GNOTYP NTRNS 1 5 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189U","description":"GYPA GNOTYP NTRNS 1 5 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00142","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","description":"CPT-00142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF0","description":"ICD-KFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior asis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1250","description":"Anterior asis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE0","description":"ICD-CICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2a/180","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0145","description":"Peg interferon alfa-2a/180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54105","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF1","description":"ICD-ECEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3A","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Family training & counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1027","description":"Family training & counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF0","description":"ICD-MFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69805","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA1","description":"ICD-IIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA1","description":"ICD-MDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC1","description":"ICD-OKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF1","description":"ICD-OGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr extnd >4 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4410","description":"Ost skn barr extnd >4 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE1","description":"ICD-OFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc gastro 51 gene nomogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007M","description":"Onc gastro 51 gene nomogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC0","description":"ICD-KBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB1","description":"ICD-CHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of acth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82024","description":"Assay of acth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE0","description":"ICD-JINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF1","description":"ICD-LHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove pituit tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62165","description":"Remove pituit tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB24","description":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC0","description":"ICD-GBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7956","description":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF0","description":"ICD-GCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA0","description":"ICD-JHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE0","description":"ICD-JEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC0","description":"ICD-JBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB34","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA0","description":"ICD-JDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gr27 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2371","description":"Gr27 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB0","description":"ICD-ICHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA1","description":"ICD-KBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD1","description":"ICD-JELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA06","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69605","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2211","description":"Pneumatic propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75840","description":"Vein x-ray adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE231","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88166","description":"Cytopath tbs c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF0","description":"ICD-FGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychoanalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90845","description":"Psychoanalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA0","description":"ICD-NEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Above knee hydracadence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5610","description":"Above knee hydracadence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Water circ cold pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0218","description":"Water circ cold pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose ped/adol im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90744","description":"Hepb vacc 3 dose ped/adol im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE1","description":"ICD-GIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD0","description":"ICD-BEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5139","description":"HCPCS-Q5139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tacrolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7525","description":"Tacrolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj sulf hexa lipid microsph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9950","description":"Inj sulf hexa lipid microsph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 4 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95864","description":"Muscle test 4 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC225","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC0","description":"ICD-JBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB1","description":"ICD-CIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0004","description":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD0","description":"ICD-KEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID0","description":"ICD-CAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD0","description":"ICD-FEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD0","description":"ICD-OIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9852","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isolation- tooth w rubb dam","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3910","description":"Isolation- tooth w rubb dam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8G","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE0","description":"ICD-ODVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF1","description":"ICD-FAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME0","description":"ICD-OKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE1","description":"ICD-JEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27654","description":"Repair of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB0","description":"ICD-JEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF1","description":"ICD-OBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stoma cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5055","description":"Stoma cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9247","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9247","description":"CDT-D9247","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1mg (Kanuma)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9478","description":"Injection_ sebelipase alfa_ 1mg (Kanuma)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF1","description":"ICD-MILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB1","description":"ICD-KIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj iv push","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96374","description":"Ther/proph/diag inj iv push","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remv/replc penis pros compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54417","description":"Remv/replc penis pros compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 7-8 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98928","description":"Osteopath manj 7-8 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","description":"HCPCS-G0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA0","description":"ICD-NATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE0","description":"ICD-JFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hbot_ full body chamber_ 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0277","description":"Hbot_ full body chamber_ 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD1","description":"ICD-CCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28455","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postop dress & 1 cast chg bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5400","description":"Postop dress & 1 cast chg bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD0","description":"ICD-AGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB0","description":"ICD-PFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone acetate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1010","description":"Injection_ methylprednisolone acetate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB0","description":"ICD-OLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open aortofemor prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34832","description":"Open aortofemor prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB0","description":"ICD-ECMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB0","description":"ICD-NEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","description":"HCPCS-L6033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enuresis alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8270","description":"Enuresis alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC1","description":"ICD-EAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stnd hemi (low seat) whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0002","description":"Stnd hemi (low seat) whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE1","description":"ICD-PJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD0","description":"ICD-CADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX46","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD0","description":"ICD-BEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9691","description":"Patient had hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB0","description":"ICD-GBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID0","description":"ICD-ECID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC1","description":"ICD-CGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE1","description":"ICD-OAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD1","description":"ICD-PJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC0","description":"ICD-CEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sargramostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2820","description":"Sargramostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD1","description":"ICD-EFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA0","description":"ICD-ADMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD0","description":"ICD-GGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ext line w easy lock connect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4673","description":"Ext line w easy lock connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB1","description":"ICD-IGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Complete wheel lock assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2206","description":"Complete wheel lock assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC1","description":"ICD-DCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21720","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optic nerve head eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2027F","description":"Optic nerve head eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE1","description":"ICD-KGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC1","description":"ICD-AHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene major bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81206","description":"Bcr/abl1 gene major bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch support remov prem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3030","description":"Foot arch support remov prem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0203","description":"HCPCS-B0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF0","description":"ICD-IITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF1","description":"ICD-KBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB1","description":"ICD-KFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1110T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1110T","description":"CPT-1110T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phys exam for college","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0622","description":"Phys exam for college","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33853","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD1","description":"ICD-KDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA1","description":"ICD-IDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0484U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","description":"CPT-0484U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28104","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE250","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63003","description":"Remove spine lamina 1/2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipoprotein(a)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83695","description":"Assay of lipoprotein(a)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28225","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9034","description":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE0","description":"ICD-ODWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Actin (Smooth Muscle) Antibody (Asma)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86015","description":"Actin (Smooth Muscle) Antibody (Asma)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA0","description":"ICD-FDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose monitor home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0607","description":"Blood glucose monitor home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00813","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","description":"CPT-00813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC0","description":"ICD-GFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iop down >15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3284F","description":"Iop down >15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX46","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE1","description":"ICD-CEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD1","description":"ICD-FBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA0","description":"ICD-KCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE0","description":"ICD-GABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0024","description":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m apcitide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9504","description":"Tc99m apcitide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5931","description":"Surgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE0","description":"ICD-PBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2005","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2005","description":"CDT-D2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE0","description":"ICD-PKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF0","description":"ICD-HCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assess hlth/behave subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96151","description":"Assess hlth/behave subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF1","description":"ICD-NAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us exam pelvic complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76856","description":"Us exam pelvic complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE1","description":"ICD-KCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA0","description":"ICD-KDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE1","description":"ICD-KBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA1","description":"ICD-CFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE1","description":"ICD-OIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1016","description":"Case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemostats for dialysis_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1637","description":"Hemostats for dialysis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE0","description":"ICD-NCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB41","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD0","description":"ICD-FFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA0","description":"ICD-MEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1601","description":"CDT-D1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB0","description":"ICD-EBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA0","description":"ICD-OIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD245","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE0","description":"ICD-BATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB52","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC50","description":"Ultra High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF1","description":"ICD-PGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC0","description":"ICD-MICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA1","description":"ICD-NKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9997","description":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26450","description":"Incision of palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD201","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2104","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES317","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10.1-30 sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14021","description":"Tis trnfr s/a/l 10.1-30 sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB1","description":"ICD-FGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF1","description":"ICD-NKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB1","description":"ICD-FAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF1","description":"ICD-KDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0941T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","description":"CPT-0941T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2350","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64490","description":"Inj paravert f jnt c/t 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC1","description":"ICD-JCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammo bx proven malig docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3350F","description":"Mammo bx proven malig docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB1","description":"ICD-MDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC0","description":"ICD-FAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE0","description":"ICD-OLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE1","description":"ICD-NITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8598","description":"Asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC1","description":"ICD-OKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB0","description":"ICD-GGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serum immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86320","description":"Serum immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA0","description":"ICD-MJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78014","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3225","description":"Mans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE1","description":"ICD-EFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB53","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC1","description":"ICD-NEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF1","description":"ICD-KGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE0","description":"ICD-CIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF1","description":"ICD-NEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0035","description":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD0","description":"ICD-MEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWA0","description":"ICD-DHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6460","description":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD113","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC21","description":"ICD-3EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37183","description":"Remove hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9378","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26530","description":"Revise knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND1","description":"ICD-OJND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD1","description":"ICD-MLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Custom fabricate w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2609","description":"Custom fabricate w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD0","description":"ICD-KHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF1","description":"ICD-CBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC41","description":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE0","description":"ICD-NEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE1","description":"ICD-OCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65600","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9812","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9812","description":"HCPCS-C9812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","description":"HCPCS-J2804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB0","description":"ICD-BETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Forearm or wrist surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25999","description":"Forearm or wrist surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1178","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB1","description":"ICD-NICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB1","description":"ICD-KIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE1","description":"ICD-FDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB0","description":"ICD-OCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE0","description":"ICD-ACTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA1","description":"ICD-KHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD0","description":"ICD-JEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8I","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC0","description":"ICD-LBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9113","description":"Onc dx ovarian stg1a-b no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE0","description":"ICD-HFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6061","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB1","description":"ICD-FFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD0","description":"ICD-JDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2105","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA1","description":"ICD-JHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA1","description":"ICD-BHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87594","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","description":"CPT-87594","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF0","description":"ICD-CDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9292","description":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin-based indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2710","description":"Crown resin-based indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Or Care Partner Decline Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0036","description":"Patient Or Care Partner Decline Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Habil res waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2017","description":"Habil res waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xray place dist ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75959","description":"Xray place dist ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83935","description":"Assay of urine osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE1","description":"ICD-EELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB0","description":"ICD-NKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethral lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57230","description":"Repair of urethral lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID0","description":"ICD-GFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF0","description":"ICD-JEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC1","description":"ICD-GGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26130","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6088","description":"Implant Supported Crown - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1012","description":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disease modif pharmacothxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4540F","description":"Disease modif pharmacothxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hallus-valgus nt dyn pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3100","description":"Hallus-valgus nt dyn pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB1","description":"ICD-GCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection torsemide 10 mg/ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3265","description":"Injection torsemide 10 mg/ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61140","description":"Pierce skull for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD0","description":"ICD-KAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC0","description":"ICD-KACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD0","description":"ICD-KDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21267","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB1","description":"ICD-BITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA1","description":"ICD-OCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neonate crit care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99468","description":"Neonate crit care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72130","description":"Ct chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD0","description":"ICD-EBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA1","description":"ICD-CBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC1","description":"ICD-DEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA0","description":"ICD-OEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Postsurgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5932","description":"Postsurgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of midface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21188","description":"Reconstruction of midface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF0","description":"ICD-GADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF1","description":"ICD-MJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC0","description":"ICD-PKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise vag graft open abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57296","description":"Revise vag graft open abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME1","description":"ICD-ABME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Uppr gi scope w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43236","description":"Uppr gi scope w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative AI-based facial phenotype analysis with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0731T","description":"Augmentative AI-based facial phenotype analysis with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD0","description":"ICD-JBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgimend_ fetal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9358","description":"Surgimend_ fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447T","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tendon excision palm/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26145","description":"Tendon excision palm/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA40","description":"Medium Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis training complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90989","description":"Dialysis training complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE1","description":"ICD-LCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB0","description":"ICD-GFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scope plantar fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29893","description":"Scope plantar fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB1","description":"ICD-CFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29583","description":"Apply multlay comprs upr arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB0","description":"ICD-OESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Breath tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2326","description":"Breath tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB0","description":"ICD-OEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB1","description":"ICD-OJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE1","description":"ICD-GCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA1","description":"ICD-FGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME1","description":"ICD-AAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC245","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC1","description":"ICD-OBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial prenatal care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500F","description":"Initial prenatal care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA1","description":"ICD-KDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee ext/flex w act res ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1812","description":"Knee ext/flex w act res ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE105","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD1","description":"ICD-GHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE1","description":"ICD-GFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF1","description":"ICD-JBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA0","description":"ICD-JFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE1","description":"ICD-GBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD0","description":"ICD-KCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE1","description":"ICD-CGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2 contents gas cubic ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8120","description":"O2 contents gas cubic ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA1","description":"ICD-DFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1602","description":"CDT-D1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB1","description":"ICD-IFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1742","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1742","description":"HCPCS-C1742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE217","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9994","description":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA0","description":"ICD-NDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB104","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3390F","description":"Ajcc cln cncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB1","description":"ICD-EGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC31","description":"ICD-2EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID1","description":"ICD-IAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92511","description":"Nasopharyngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF1","description":"ICD-JDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0694T","description":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1C","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90620","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF1","description":"ICD-HHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA0","description":"ICD-IIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC0","description":"ICD-IDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF1","description":"ICD-EDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD0","description":"ICD-FIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA0","description":"ICD-OFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD0","description":"ICD-OLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE0","description":"ICD-FHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE1","description":"ICD-NHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB1","description":"ICD-DAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC0","description":"ICD-MHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1103","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC0","description":"ICD-IGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB0","description":"ICD-GHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC0","description":"ICD-JFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repos nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432T","description":"Repos nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE1","description":"ICD-GAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE1","description":"ICD-JIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE0","description":"ICD-NIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD1","description":"ICD-NADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC1","description":"ICD-JBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Term dev precision pinch dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6810","description":"Term dev precision pinch dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB1","description":"ICD-DHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27030","description":"Drainage of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC1","description":"ICD-FGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17263","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD1","description":"ICD-CGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental recement crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2920","description":"Dental recement crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef >/=40% systolic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3022F","description":"Lvef >/=40% systolic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD1","description":"ICD-MFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1A","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1300","description":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26415","description":"Excision hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64868","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB1","description":"ICD-NGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA0","description":"ICD-OEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elisa hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0433","description":"Elisa hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Io rad tx delivery by x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77424","description":"Io rad tx delivery by x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB1","description":"ICD-EETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD0","description":"ICD-OIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE0","description":"ICD-AIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32671","description":"Thoracoscopy pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii vw antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85246","description":"Clot factor viii vw antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67141","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27380","description":"Repair of kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB1","description":"ICD-NEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF0","description":"ICD-CFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC1","description":"ICD-PCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE1","description":"ICD-IDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73222","description":"MRI joint upr extrem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2079","description":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD1","description":"ICD-KCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB160","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD0","description":"ICD-IDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA0","description":"ICD-MHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE1","description":"ICD-IDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB126","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD0","description":"ICD-KBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-each additional 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9221","description":"Deep sedation/general anesthesia-each additional 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8I","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC1","description":"ICD-HIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE0","description":"ICD-NFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE1","description":"ICD-PIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA0","description":"ICD-KFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME0","description":"ICD-FAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF1","description":"ICD-EFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD0","description":"ICD-JBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF1","description":"ICD-OHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB1","description":"ICD-NIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73110","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4284","description":"Dermabind sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy sterilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58565","description":"Hysteroscopy sterilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC140","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6015F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF0","description":"ICD-OBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9061","description":"Injection_ teprotumumab-trbw_10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate swallowing function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92610","description":"Evaluate swallowing function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA0","description":"ICD-MLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11960","description":"Insert tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1356","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGC1","description":"ICD-FGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA1","description":"ICD-GGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0780","description":"Prochlorperazine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA1","description":"ICD-MJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND1","description":"ICD-GGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB1","description":"ICD-IEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62225","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9361","description":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5A","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD1","description":"ICD-CCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33463","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA0","description":"ICD-FGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 2nd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36246","description":"Ins cath abd/l-ext art 2nd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23550","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert card electrodes dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33211","description":"Insert card electrodes dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA0","description":"ICD-GFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE1","description":"ICD-AHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF0","description":"ICD-PIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA131","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD0","description":"ICD-KCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99457","description":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB1","description":"ICD-PGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB0","description":"ICD-GIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME1","description":"ICD-EBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE0","description":"ICD-BAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8869","description":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0532","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","description":"HCPCS-G0532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC1","description":"ICD-BGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD1","description":"ICD-DGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF1","description":"ICD-FHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77280","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hernia repair < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83451","description":"Anesth hernia repair < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7685","description":"Tobramycin comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51700","description":"Irrigation of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC0","description":"ICD-IEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF1","description":"ICD-GGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF1","description":"ICD-JHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81285","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF1","description":"ICD-NLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB0","description":"ICD-PHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA1","description":"ICD-GFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2208","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF0","description":"ICD-IDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB1","description":"ICD-LDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93620","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA1","description":"ICD-CARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD1","description":"ICD-FDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC1","description":"ICD-JHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED1","description":"ICD-JIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC60","description":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE214","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20704","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sperm pouch lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55680","description":"Remove sperm pouch lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Risperidone_ long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2794","description":"Risperidone_ long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF0","description":"ICD-PEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1111","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB0","description":"ICD-FHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD1","description":"ICD-FAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB31","description":"ICD-1JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 4 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP04","description":"Auto.test pane pricing code_ 4 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB0","description":"ICD-IAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9097","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0907T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","description":"CPT-0907T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3253","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","description":"CPT-01712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1079","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE0","description":"ICD-IDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29131","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33875","description":"Thoracic aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF1","description":"ICD-EBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE0","description":"ICD-NGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81558","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","description":"CPT-81558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425T","description":"Insj/rplc nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56751","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC1","description":"ICD-OFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45160","description":"Excision of rectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC1","description":"ICD-IFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx dprsd zygomatic arch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21356","description":"Opn tx dprsd zygomatic arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF1","description":"ICD-AIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF1","description":"ICD-KEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Propulsion whl excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2224","description":"Propulsion whl excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77407","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE1","description":"ICD-NELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev soft tiss 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10035","description":"Perq dev soft tiss 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4387","description":"Non-pneum walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90999","description":"Dialysis procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2003","description":"CDT-D2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65222","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv unsure baby of hiv+moms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3491F","description":"Hiv unsure baby of hiv+moms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0940","description":"Trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36100","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfusion procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86999","description":"Transfusion procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewho erbs palsey design abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3962","description":"Sewho erbs palsey design abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE1","description":"ICD-CARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE0","description":"ICD-OJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB0","description":"ICD-GEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC0","description":"ICD-OETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD1","description":"ICD-IFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF1","description":"ICD-IABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2010","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0A","description":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD0","description":"ICD-GGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE0","description":"ICD-OCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB0","description":"ICD-BEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA0","description":"ICD-NIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Co-morbid condition assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1026F","description":"Co-morbid condition assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB1","description":"ICD-JHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2139","description":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE1","description":"ICD-NBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF0","description":"ICD-BFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61591","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB0","description":"ICD-MGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"A/d halfway house_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2034","description":"A/d halfway house_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00811","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","description":"CPT-00811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9037","description":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0559","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","description":"HCPCS-G0559","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB0","description":"ICD-NACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49565","description":"Rerepair ventrl hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA1","description":"ICD-CBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15732","description":"Muscle-skin graft head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD1","description":"ICD-JHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC0","description":"ICD-OGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE1","description":"ICD-DBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD1","description":"ICD-CDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA110","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164U","description":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0505","description":"HCPCS-B0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF0","description":"ICD-CGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE0","description":"ICD-KGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA1","description":"ICD-FGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC0","description":"ICD-OHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE1","description":"ICD-FDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF1","description":"ICD-IBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer for use w/ regulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0580","description":"Nebulizer for use w/ regulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF0","description":"ICD-NCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl smear w/o diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85008","description":"Bl smear w/o diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC21","description":"ICD-4GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange dirprobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81341","description":"Trb@ gene rearrange dirprobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA0","description":"ICD-LEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE0","description":"ICD-DAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung bx plug w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2613","description":"Lung bx plug w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED0","description":"ICD-FHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF0","description":"ICD-KGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE1","description":"ICD-OGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB0","description":"ICD-BDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay carboxyhb qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82376","description":"Assay carboxyhb qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal monitor/interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59051","description":"Fetal monitor/interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD1","description":"ICD-HESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD1","description":"ICD-IGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA1","description":"ICD-GAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gjb6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81254","description":"Gjb6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32220","description":"Release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC1","description":"ICD-GIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0A","description":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF0","description":"ICD-JCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD0","description":"ICD-NLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8809","description":"Rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"(Rapivab) Injection_ Peramivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9451","description":"(Rapivab) Injection_ Peramivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA0","description":"ICD-CBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA0","description":"ICD-ECDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","description":"CPT-00820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX51","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41250","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0657U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0657U","description":"CPT-0657U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0536U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","description":"CPT-0536U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84126","description":"Assay of feces porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74263","description":"Ct colonography screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0912T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","description":"CPT-0912T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0104","description":"Structured Day Habilitation Group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair upper jaw fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30580","description":"Repair upper jaw fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 2400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0243","description":"Injection_ casirivimab and imdevimab_ 2400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28585","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatorrhaphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48545","description":"Pancreatorrhaphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tubing used w suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7002","description":"Tubing used w suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7527","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69120","description":"Removal of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA0","description":"ICD-KBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA1","description":"ICD-BCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC1","description":"ICD-JAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA0","description":"ICD-LHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair art intramural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33507","description":"Repair art intramural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD0","description":"ICD-KFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB1","description":"ICD-CINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98975","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97002","description":"Pt re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebond/cement/repair retain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8693","description":"Rebond/cement/repair retain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Norsn not first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9314","description":"Norsn not first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB1","description":"ICD-BGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1605","description":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 17-24 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2260","description":"Induced abortion 17-24 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF0","description":"ICD-OAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID0","description":"ICD-CIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC250","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9362","description":"HCPCS-J9362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF1","description":"ICD-GGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8540","description":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Depression screen annual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0444","description":"Depression screen annual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE0","description":"ICD-CHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA21","description":"ICD-3EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC0","description":"ICD-MEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13100","description":"Cmplx rpr trunk 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve init insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31647","description":"Bronchial valve init insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9986","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA0","description":"ICD-KFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61710","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF1","description":"ICD-BBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA1","description":"ICD-OECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB0","description":"ICD-OIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0136","description":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8663","description":"Fun stat score shdl >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB1","description":"ICD-CACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97164","description":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22837","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8614","description":"Cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA0","description":"ICD-KHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microbe suscept macrobroth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87188","description":"Microbe suscept macrobroth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin sig dep sym by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3354F","description":"Clin sig dep sym by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC1","description":"ICD-ODJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA1","description":"ICD-DBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD1","description":"ICD-FBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temporal bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69979","description":"Temporal bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pne scrn done doc not ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9281","description":"Pne scrn done doc not ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA0","description":"ICD-NGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD1","description":"ICD-ODJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB0","description":"ICD-GHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD1","description":"ICD-CDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE0","description":"ICD-NFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27535","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymph node biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38570","description":"Laparoscopy lymph node biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6533","description":"Gc stocking thighlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB1","description":"ICD-CBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD1","description":"ICD-KIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD1","description":"ICD-GHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6251","description":"Absorpt drg <=16 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of csf protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83873","description":"Assay of csf protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coccidioidomycosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86490","description":"Coccidioidomycosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noonan spectrum disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81442","description":"Noonan spectrum disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4018","description":"Cast sup lng arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF1","description":"ICD-HFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FlowerAmnioPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4178","description":"FlowerAmnioPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rig ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1233","description":"Rig ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD1","description":"ICD-ADUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE1","description":"ICD-AAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8611","description":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24134","description":"Removal of arm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD0","description":"ICD-DAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE1","description":"ICD-OLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF1","description":"ICD-OGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC0","description":"ICD-CIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40700","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01772","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","description":"CPT-01772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC0","description":"ICD-MCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49611","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA0","description":"ICD-BBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92544","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43605","description":"Biopsy of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC0","description":"ICD-ADCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA1","description":"ICD-CAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psych hlth fac svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2013","description":"Psych hlth fac svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME1","description":"ICD-EFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","description":"HCPCS-A6611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE1","description":"ICD-NIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD1","description":"ICD-KEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF0","description":"ICD-BBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26952","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung perf&ventilat diferentl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78598","description":"Lung perf&ventilat diferentl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB1","description":"ICD-NCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB0","description":"ICD-ODIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF0","description":"ICD-OHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID0","description":"ICD-GHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF0","description":"ICD-OFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9148","description":"Medical home level 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE1","description":"ICD-OLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA0","description":"ICD-MBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB130","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA0","description":"ICD-AADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC125","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1149","description":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX15","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29889","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC0","description":"ICD-MJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","description":"HCPCS-Q4356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1904","description":"HCPCS-C1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE1","description":"ICD-ADDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thumb tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26510","description":"Thumb tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC1","description":"ICD-CIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of apolipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82172","description":"Assay of apolipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","description":"HCPCS-L1006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE0","description":"ICD-GDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD1","description":"ICD-HBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF1","description":"ICD-HGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC0","description":"ICD-JDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coat/cov w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1877","description":"Stent_ non-coat/cov w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD0","description":"ICD-KEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA1","description":"ICD-OLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1030","description":"Patients with clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB1","description":"ICD-IAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post >=4srfc resinbase cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2394","description":"Post >=4srfc resinbase cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Embedded ip cath exit-site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49436","description":"Embedded ip cath exit-site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace blood leak detector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1560","description":"Replace blood leak detector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27466","description":"Lengthening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Powered pres-redu air mattrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0277","description":"Powered pres-redu air mattrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ferritin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82728","description":"Assay of ferritin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE0","description":"ICD-MBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29550","description":"Strapping of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6098","description":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB1","description":"ICD-JBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF1","description":"ICD-CDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86808","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 no remiss >=5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9395","description":"Ini phq9 >9 no remiss >=5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA0","description":"ICD-GGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4D","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spec gene test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3866","description":"Spec gene test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corf skilled nursing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0128","description":"Corf skilled nursing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC1","description":"ICD-MEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD0","description":"ICD-KFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Hpc 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9986","description":"Injection Hpc 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE1","description":"ICD-HHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC0","description":"ICD-CGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8080","description":"Compre dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB1","description":"ICD-IITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB146","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 1999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4722","description":"Dialys sol fld vol > 1999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Localized delivery antimicro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4381","description":"Localized delivery antimicro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF0","description":"ICD-NLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC1","description":"ICD-CHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54130","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Main/clean max prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5993","description":"Main/clean max prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33426","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF0","description":"ICD-PHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA1","description":"ICD-BBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB1","description":"ICD-PJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove elctrd transvenously","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33244","description":"Remove elctrd transvenously","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC1","description":"ICD-KHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt info into recall system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7010F","description":"Pt info into recall system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Case management_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2022","description":"Case management_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB0","description":"ICD-CFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE1","description":"ICD-MCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33930","description":"Removal of donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esano ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4274","description":"Esano ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF1","description":"ICD-KASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF1","description":"ICD-IHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB1","description":"ICD-GGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA1","description":"ICD-FAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD1","description":"ICD-KDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94060","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73030","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tongue base vol reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41530","description":"Tongue base vol reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB230","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374T","description":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6584","description":"Gradient compression wrap with adjustable straps_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF1","description":"ICD-FHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA1","description":"ICD-MEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0496T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD0","description":"ICD-OBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1022","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hg a1c level 7.0-9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3045F","description":"Hg a1c level 7.0-9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy tubal block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58671","description":"Laparoscopy tubal block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50010","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC0","description":"ICD-CFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID1","description":"ICD-KEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB0","description":"ICD-JFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardioassist internal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92970","description":"Cardioassist internal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB1","description":"ICD-KFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC1","description":"ICD-CDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB0","description":"ICD-NIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tricyclic & cyclicals 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80337","description":"Tricyclic & cyclicals 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC11","description":"ICD-4KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpowered pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0373","description":"Nonpowered pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1466","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","description":"HCPCS-M1466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2021","description":"Com wrap-around sv_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23466","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF0","description":"ICD-JADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB1","description":"ICD-CAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE254","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91317","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ bivalent spike protein_ preservative free_ 3 mcg/0.2 mL dosage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Capillary blood draw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36416","description":"Capillary blood draw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE1","description":"ICD-JEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temsirolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9330","description":"Temsirolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0826T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD0","description":"ICD-OJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB1","description":"ICD-JALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA0","description":"ICD-BAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF0","description":"ICD-AFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF0","description":"ICD-IEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA1","description":"ICD-EBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA1","description":"ICD-OAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC0","description":"ICD-AGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA1","description":"ICD-PLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF0","description":"ICD-BHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF1","description":"ICD-OISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81523","description":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA1","description":"ICD-JFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE131","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB1","description":"ICD-ODCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA14","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69320","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF0","description":"ICD-OFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC1","description":"ICD-OJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1820","description":"Soft interface material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urethrlys transvag w/ scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53500","description":"Urethrlys transvag w/ scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0491T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE0","description":"ICD-JDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levoleucovorin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0641","description":"Levoleucovorin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1179","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise/graft midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28305","description":"Incise/graft midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In111 pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9548","description":"In111 pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supra SDRM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2011","description":"Supra SDRM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electric wound treatment dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0769","description":"Electric wound treatment dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB0","description":"ICD-OKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Y set tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4719","description":"Y set tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD1","description":"ICD-KEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD0","description":"ICD-NHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE1","description":"ICD-CHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF0","description":"ICD-HBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD1","description":"ICD-MGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA0","description":"ICD-MDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD0","description":"ICD-OARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD0","description":"ICD-LBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8I","description":"Very High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sgd w multi methods msg/accs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2510","description":"Sgd w multi methods msg/accs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1129","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE0","description":"ICD-EHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj atr elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410T","description":"Insj/rplc car modulj atr elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD1","description":"ICD-IFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC0","description":"ICD-CDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND0","description":"ICD-FEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC1","description":"ICD-CHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","description":"CPT-70473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA0","description":"ICD-GEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID1","description":"ICD-JFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA31","description":"ICD-4KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pozelimab-bbfg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9376","description":"Injection_ pozelimab-bbfg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"John cunningham antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86711","description":"John cunningham antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6577","description":"Gradient compression arm sleeve_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE1","description":"ICD-FHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27049","description":"Resect hip/pelv tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70482","description":"Ct orbit/ear/fossa w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68705","description":"Revise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE130","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB0","description":"ICD-NCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF0","description":"ICD-JAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5247","description":"Hearing aid_ prog_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE1","description":"ICD-OAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB0","description":"ICD-KIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interp both jaw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0367","description":"Cone beam ct interp both jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27355","description":"Remove femur lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinal male jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0325","description":"Urinal male jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB1","description":"ICD-FIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chin cup interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2324","description":"Chin cup interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD0","description":"ICD-AAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA1","description":"ICD-GIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE0","description":"ICD-KHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93893","description":"Tcd emboli detect w/inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ delafloxacin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9462","description":"Injection_ delafloxacin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Barium swallow test not req","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3200F","description":"Barium swallow test not req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76881","description":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE1","description":"ICD-JCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0405","description":"HCPCS-A0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB0","description":"ICD-ACAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged iv inf_ req pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8957","description":"Prolonged iv inf_ req pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Didanosine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0137","description":"Didanosine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA1","description":"ICD-NFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE0","description":"ICD-OFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis treatment performed exactly three times per week for > 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8714","description":"Hemodialysis treatment performed exactly three times per week for > 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB1","description":"ICD-GGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID0","description":"ICD-FIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE0","description":"ICD-MFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debride skin at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11010","description":"Debride skin at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0827T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA0","description":"ICD-OLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21182","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD0","description":"ICD-NKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF1","description":"ICD-KFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC1","description":"ICD-OBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gross pulpal debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3221","description":"Gross pulpal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD0","description":"ICD-FFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC1","description":"ICD-JIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE0","description":"ICD-KCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC125","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8I","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB146","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD1","description":"ICD-BADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB0","description":"ICD-OBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC0","description":"ICD-CILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA1","description":"ICD-MCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371T","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB1","description":"ICD-MJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD1","description":"ICD-OIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA1","description":"ICD-LCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corf related serv 15 mins ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0409","description":"Corf related serv 15 mins ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infrared therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97026","description":"Infrared therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB0","description":"ICD-AHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection Nusinersen 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9489","description":"Injection Nusinersen 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA1","description":"ICD-MLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE1","description":"ICD-NAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA1","description":"ICD-JALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC1","description":"ICD-IBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE0","description":"ICD-MLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pasrr level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2010","description":"Pasrr level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE1","description":"ICD-MGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0518","description":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC1","description":"ICD-MDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1007T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","description":"CPT-1007T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE1","description":"ICD-OGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA0","description":"ICD-JBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47425","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC31","description":"ICD-3FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evacuate mole of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59870","description":"Evacuate mole of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise anal ext tag/papilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46220","description":"Excise anal ext tag/papilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA0","description":"ICD-FFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB40","description":"Ultra High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4215","description":"Sterile needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73521","description":"X-ray exam hips bi 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9752","description":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB0","description":"ICD-OFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB1","description":"ICD-OKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD1","description":"ICD-CGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum albumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82040","description":"Assay of serum albumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC0","description":"ICD-MALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resin-based composite - four or more surfaces (anterior)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2335","description":"Resin-based composite - four or more surfaces (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA0","description":"ICD-FFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0643","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0643","description":"HCPCS-J0643","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA0","description":"ICD-MIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC0","description":"ICD-CHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5700","description":"Replace socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11642","description":"Exc f/e/e/n/l mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC1","description":"ICD-ODUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC1","description":"ICD-BEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","description":"CPT-01770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC1","description":"ICD-MAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE1","description":"ICD-CANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC1","description":"ICD-OAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF1","description":"ICD-CIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High inten beh couns std 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0445","description":"High inten beh couns std 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF0","description":"ICD-BDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB0","description":"ICD-GCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB1","description":"ICD-NLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD1","description":"ICD-FALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenytoin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80186","description":"Assay of phenytoin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL46","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC1","description":"ICD-OAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam no pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96155","description":"Interv hlth/behav fam no pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC0","description":"ICD-NEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86277","description":"Growth hormone antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Allowrap ds or dry 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4150","description":"Allowrap ds or dry 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB1","description":"ICD-KGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wedging of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29740","description":"Wedging of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF0","description":"ICD-NHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB0","description":"ICD-IDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE0","description":"ICD-NFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB1","description":"ICD-AGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD1","description":"ICD-OEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA0","description":"ICD-IEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0493","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC1","description":"ICD-ICHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC1","description":"ICD-AEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC1","description":"ICD-CACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC1","description":"ICD-CITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD0","description":"ICD-KEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2D","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC130","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA1","description":"ICD-OFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE0","description":"ICD-OLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF1","description":"ICD-LHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC51","description":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28202","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA1","description":"ICD-KGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43420","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93596","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA0","description":"ICD-GFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB1","description":"ICD-AELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB1","description":"ICD-OIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect enlarged toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28341","description":"Resect enlarged toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB0","description":"ICD-KEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE1","description":"ICD-ICAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB0","description":"ICD-JFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1037","description":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1018","description":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16370","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16370","description":"CPT-16370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE0","description":"ICD-MCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental Case Management - Patients With Special Health Care Needs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9997","description":"Dental Case Management - Patients With Special Health Care Needs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA0","description":"ICD-CBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE1","description":"ICD-NDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA1","description":"ICD-NBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0B","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE0","description":"ICD-FDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd remove lesion snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43251","description":"Egd remove lesion snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine patch legend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4990","description":"Nicotine patch legend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC1","description":"ICD-LAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bleomycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9040","description":"Bleomycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB1","description":"ICD-ODWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tr retinal les preterm inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67229","description":"Tr retinal les preterm inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mech amb infusion pump <8hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0780","description":"Mech amb infusion pump <8hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA0","description":"ICD-BDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7521","description":"Trach/laryn tube cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Us bone density measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76977","description":"Us bone density measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nfct agent detection gi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87505","description":"Nfct agent detection gi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96203","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME1","description":"ICD-CEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD0","description":"ICD-NAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC1","description":"ICD-NFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3471F","description":"Ra disease activity mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC1","description":"ICD-JEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11404","description":"Exc tr-ext b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE1","description":"ICD-FGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF0","description":"ICD-LFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF0","description":"ICD-NDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA1","description":"ICD-NBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified biologics","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3590","description":"Unclassified biologics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sugars multiple qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84377","description":"Sugars multiple qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES310","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD0","description":"ICD-BAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA1","description":"ICD-GEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC1","description":"ICD-DDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF1","description":"ICD-NILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE0","description":"ICD-DFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy comp/disp serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9430","description":"Pharmacy comp/disp serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB0","description":"ICD-AFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0505U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","description":"CPT-0505U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion unilat rot str","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2070","description":"Hkafo torsion unilat rot str","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert needle bone cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36680","description":"Insert needle bone cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA1","description":"ICD-EHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB1","description":"ICD-DCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1062T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1062T","description":"CPT-1062T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Performance Met: The Residual Change Score Is Equal To Or Greater Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2152","description":"Performance Met: The Residual Change Score Is Equal To Or Greater Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc_ l/r_ cmv-neg_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9058","description":"Rbc_ l/r_ cmv-neg_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD0","description":"ICD-NBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE0","description":"ICD-PFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA44","description":"Medium Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA24","description":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air ambulan nonemerg rotary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9961","description":"Air ambulan nonemerg rotary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC0","description":"ICD-CDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD1","description":"ICD-EDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF1","description":"ICD-NCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA1","description":"ICD-MKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9700","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove coronoid process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21070","description":"Remove coronoid process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE1","description":"ICD-FBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE0","description":"ICD-JIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58300","description":"Insert intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104U","description":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC0","description":"ICD-CDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB0","description":"ICD-PAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA0","description":"ICD-MKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7680","description":"Terbutaline sulf comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB1","description":"ICD-OIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal scalp blood sample","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59030","description":"Fetal scalp blood sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC1","description":"ICD-GABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB31","description":"ICD-3EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0592T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25690","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95719","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrog device eval heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93289","description":"Interrog device eval heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD0","description":"ICD-MFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ocular photodynamic ther","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67221","description":"Ocular photodynamic ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93042","description":"Rhythm ecg report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB1","description":"ICD-BBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit for hemodialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99512","description":"Home visit for hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB0","description":"ICD-KHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33370","description":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA1","description":"ICD-KILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE1","description":"ICD-FECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4243","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4243","description":"HCPCS-Q4243","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB1","description":"ICD-LFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35188","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","description":"CPT-00215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD1","description":"ICD-OBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5949","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5949","description":"CDT-D5949","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2080","description":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB0","description":"ICD-CEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27254","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81173","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF1","description":"ICD-KHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE0","description":"ICD-JIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX01","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adults who are not ambulatory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1068","description":"Adults who are not ambulatory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42408","description":"Excision of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE156","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC0","description":"ICD-EGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ pacing_ transesoph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1756","description":"Cath_ pacing_ transesoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF1","description":"ICD-GIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA1","description":"ICD-ODXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0516","description":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB0","description":"ICD-BAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1349","description":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Frozen plasma_ pooled_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9023","description":"Frozen plasma_ pooled_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44950","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD110","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB0","description":"ICD-JIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED0","description":"ICD-CHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE0","description":"ICD-CFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21083","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61618","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem focal defic constant fri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5230","description":"Fem focal defic constant fri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE1","description":"ICD-IAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0601U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","description":"CPT-0601U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF1","description":"ICD-MKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF1","description":"ICD-OAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC0","description":"ICD-ECIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB1","description":"ICD-OJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","description":"CPT-01214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB1","description":"ICD-IETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73223","description":"MRI joint upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB1","description":"ICD-KCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8878","description":"Sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26432","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME1","description":"ICD-JDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ ureteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1758","description":"Catheter_ ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6597","description":"Gradient compression bandage roll_ elastic long stretch_ linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF1","description":"ICD-OABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE1","description":"ICD-BEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD1","description":"ICD-FEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB1","description":"ICD-ODSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA1","description":"ICD-IHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA0","description":"ICD-BBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC0","description":"ICD-KDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emerge matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4297","description":"Emerge matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37291","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","description":"CPT-37291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise nerve back of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64744","description":"Incise nerve back of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA1","description":"ICD-CENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26518","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD1","description":"ICD-NKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB0","description":"ICD-GCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24077","description":"Resect arm/elbow tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Copy number (EG_ intellectual disability_ dysmorphology)_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0156U","description":"Copy number (EG_ intellectual disability_ dysmorphology)_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE1","description":"ICD-KFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD0","description":"ICD-CFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd shck absrber for hd powwc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1018","description":"Hd shck absrber for hd powwc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Macul result phy/qhp mng dm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5010F","description":"Macul result phy/qhp mng dm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID0","description":"ICD-ACID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB0","description":"ICD-FIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD1","description":"ICD-OKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0718T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC1","description":"ICD-GEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25332","description":"Revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF1","description":"ICD-BGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28039","description":"Exc foot/toe tum sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA0","description":"ICD-FIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE1","description":"ICD-NAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA1","description":"ICD-IIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB55","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity classified mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1490F","description":"Dem severity classified mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC1","description":"ICD-ICAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95723","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1019","description":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate esophagus veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43400","description":"Ligate esophagus veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo frct swg & sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5718","description":"Knee-shin exo frct swg & sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37200","description":"Transcatheter biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cancelled appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9987","description":"Cancelled appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2134","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF0","description":"ICD-NCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE1","description":"ICD-KCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB1","description":"ICD-NEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB1","description":"ICD-BGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special childcare waiver/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2026","description":"Special childcare waiver/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC0","description":"ICD-FCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC0","description":"ICD-KEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mesh (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1781","description":"Mesh (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB0","description":"ICD-BEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tumor cell deplete of harvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38211","description":"Tumor cell deplete of harvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB1","description":"ICD-OGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF1","description":"ICD-FGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85370","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC1","description":"ICD-DERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD0","description":"ICD-HGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF0","description":"ICD-HEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF0","description":"ICD-BHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0548T","description":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt infosys alarm 4 nxt mammo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7025F","description":"Pt infosys alarm 4 nxt mammo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF1","description":"ICD-BBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC0","description":"ICD-KAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0244","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF0","description":"ICD-DHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE0","description":"ICD-PBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD1","description":"ICD-EAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0D","description":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6038","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE0","description":"ICD-GCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB1","description":"ICD-OLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA0","description":"ICD-OBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryo-Cord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4237","description":"Cryo-Cord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in inpatient psych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5008","description":"Hospice in inpatient psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD1","description":"ICD-BHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70190","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryoablate renal mass open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50250","description":"Cryoablate renal mass open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8718","description":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert xdrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63303","description":"Remov vert xdrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w supinat/pronat inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3201","description":"Oxford w supinat/pronat inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo prox th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4100","description":"Repl leath cuff kafo prox th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX21","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24147","description":"Partial removal of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnt pain noted none prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1126F","description":"Amnt pain noted none prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF0","description":"ICD-FDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc fcn/care plan w/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8942","description":"Doc fcn/care plan w/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC1","description":"ICD-OGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB0","description":"ICD-CHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Walker platform attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0154","description":"Walker platform attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01420","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","description":"CPT-01420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Written discharge instr prvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4014F","description":"Written discharge instr prvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51960","description":"Revision of bladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE0","description":"ICD-BHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA1","description":"ICD-OAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC0","description":"ICD-CFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE0","description":"ICD-CFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc oviduct-ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58679","description":"Laparo proc oviduct-ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1223","description":"Glaucoma plan of care documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD0","description":"ICD-NLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd 2 rx anti-emet agt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4558F","description":"Pt recvd 2 rx anti-emet agt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD0","description":"ICD-CDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC0","description":"ICD-CGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31572","description":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE1","description":"ICD-ODUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF0","description":"ICD-KIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC0","description":"ICD-JAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day <2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90967","description":"Esrd home pt serv p day <2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE0","description":"ICD-CHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE1","description":"ICD-OKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15610","description":"Delay flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB1","description":"ICD-OENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prostate laser enucleation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52649","description":"Prostate laser enucleation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"DermaBind FM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4313","description":"DermaBind FM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78272","description":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB0","description":"ICD-NLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE1","description":"ICD-GAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24930","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB0","description":"ICD-FGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA1","description":"ICD-GGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC0","description":"ICD-GDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 5 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7298","description":"Levonorgestrel iu 52mg 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB0","description":"ICD-MBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB1","description":"ICD-FHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF1","description":"ICD-OKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA0","description":"ICD-NBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE206","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx mult myeloma stg2 hig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9129","description":"Onc dx mult myeloma stg2 hig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD1","description":"ICD-NDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj ceftazidime per 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0713","description":"Inj ceftazidime per 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB1","description":"ICD-EBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22226","description":"Revise extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF1","description":"ICD-FEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure cpap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94660","description":"Pos airway pressure cpap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair deformity of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28313","description":"Repair deformity of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54500","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC1","description":"ICD-NIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB0","description":"ICD-CBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rev artific disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098T","description":"Rev artific disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB0","description":"ICD-KGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vis field assmnt tech suppt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379T","description":"Vis field assmnt tech suppt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm adult fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4006","description":"Cast sup long arm adult fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB1","description":"ICD-JHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE0","description":"ICD-JGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED1","description":"ICD-OFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA1","description":"ICD-IIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9803","description":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF1","description":"ICD-KHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE1","description":"ICD-JBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF0","description":"ICD-KAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA1","description":"ICD-HEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD1","description":"ICD-OGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28405","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE1","description":"ICD-MABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2623","description":"Adj skin pro wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB1","description":"ICD-FEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Promethazine hcl 12.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0169","description":"Promethazine hcl 12.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CROM GNOTYP CD55 EXONS 1-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182U","description":"CROM GNOTYP CD55 EXONS 1-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA0","description":"ICD-MJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB0","description":"ICD-JINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF1","description":"ICD-MHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7612","description":"Levalbuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0222","description":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC1","description":"ICD-OJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC1","description":"ICD-FDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Co2 breathing response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94400","description":"Co2 breathing response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA0","description":"ICD-NIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF1","description":"ICD-AFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray special views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71035","description":"Chest x-ray special views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7529","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC1","description":"ICD-DBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Construct thumb replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26550","description":"Construct thumb replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE0","description":"ICD-JHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF1","description":"ICD-KFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE1","description":"ICD-KEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC33","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC0","description":"ICD-NCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE0","description":"ICD-NLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF0","description":"ICD-KDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF0","description":"ICD-GBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD0","description":"ICD-METD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0292","description":"Hosp bed var ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC1","description":"ICD-MLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND0","description":"ICD-OIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB160","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63082","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA1","description":"ICD-PDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2865","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","description":"HCPCS-J2865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF0","description":"ICD-GIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch supp longitud/meta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3060","description":"Foot arch supp longitud/meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and reinsertion of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0511T","description":"Removal and reinsertion of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB0","description":"ICD-KFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA0","description":"ICD-OJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC1","description":"ICD-BAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electro connect btw control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2310","description":"Electro connect btw control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cad cxr remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175T","description":"Cad cxr remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF1","description":"ICD-LEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE0","description":"ICD-OEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA1","description":"ICD-EGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD1","description":"ICD-GHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME1","description":"ICD-GGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB1","description":"ICD-AFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF1","description":"ICD-MEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Upright gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8001","description":"Upright gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0163","description":"Diphenhydramine hcl 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF0","description":"ICD-HAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Midfacial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8041","description":"Midfacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB1","description":"ICD-NIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF0","description":"ICD-CDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Docetaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9171","description":"Docetaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288U","description":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD0","description":"ICD-AFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA105","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF0","description":"ICD-JGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42104","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0604","description":"HCPCS-C0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA1","description":"ICD-FFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","description":"HCPCS-J0462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA1","description":"ICD-EAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9792","description":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA0","description":"ICD-KFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD0","description":"ICD-OHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dev interrog remote 1/2/mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93295","description":"Dev interrog remote 1/2/mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE0","description":"ICD-NFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML34","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of pyloric muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43520","description":"Incision of pyloric muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC1","description":"ICD-IDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED0","description":"ICD-MBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF1","description":"ICD-JFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53405","description":"Revise urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA0","description":"ICD-JIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0236","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","description":"HCPCS-M0236","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB1","description":"ICD-PCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of cleft lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10251","description":"Anesth repair of cleft lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28080","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC1","description":"ICD-DIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE1","description":"ICD-NHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA0","description":"ICD-KCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC0","description":"ICD-FDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/heat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1405","description":"O2/water vapor enrich w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE1","description":"ICD-EFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF1","description":"ICD-JHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","description":"HCPCS-Q4378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/bone grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21408","description":"Opn tx orbit fx w/bone grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB15","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB0","description":"ICD-CEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB1","description":"ICD-CGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC11","description":"ICD-3FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50660","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD0","description":"ICD-MEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB0","description":"ICD-ODKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6110","description":"Implnt/abut remov dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE1","description":"ICD-AELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF0","description":"ICD-NELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD1","description":"ICD-KBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ex for speech device rx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92608","description":"Ex for speech device rx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF0","description":"ICD-GAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA1","description":"ICD-NKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33690","description":"Reinforce pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA0","description":"ICD-ODCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC0","description":"ICD-CBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC1","description":"ICD-OBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist disarticul switch ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6920","description":"Wrist disarticul switch ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB240","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC0","description":"ICD-OJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE1","description":"ICD-BDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF1","description":"ICD-GIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0962T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","description":"CPT-0962T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC1","description":"ICD-NLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE0","description":"ICD-NBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1070T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1070T","description":"CPT-1070T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA0","description":"ICD-KBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51020","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC1","description":"ICD-DFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA1","description":"ICD-MIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF1","description":"ICD-AEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9991","description":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF0","description":"ICD-JDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA0","description":"ICD-IGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF0","description":"ICD-MKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4379","description":"Urinary plastic pouch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF1","description":"ICD-EHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1030","description":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC0","description":"ICD-JFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF1","description":"ICD-GHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA0","description":"ICD-OFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Positional change of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26555","description":"Positional change of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tension based scoliosis orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1005","description":"Tension based scoliosis orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC21","description":"ICD-4FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB0","description":"ICD-DCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA0","description":"ICD-CDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29010","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amitriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6030","description":"Amitriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE1","description":"ICD-GFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp5 ped sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0890","description":"Pwc gp5 ped sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7569","description":"HCPCS-C7569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF0","description":"ICD-OKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii ahg 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85240","description":"Clot factor viii ahg 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA0","description":"ICD-KBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA1","description":"ICD-GCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC0","description":"ICD-EIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD0","description":"ICD-MBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB0","description":"ICD-KBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD0","description":"ICD-CDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF1","description":"ICD-OJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (xembify)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1558","description":"Injection_ immune globulin (xembify)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE0","description":"ICD-CFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA0","description":"ICD-CAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF0","description":"ICD-OJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whole blood for transfusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9010","description":"Whole blood for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC0","description":"ICD-FFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1454","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","description":"HCPCS-M1454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt tx sys bio med psori 6mth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9652","description":"Pt tx sys bio med psori 6mth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rsv mab im 50mg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90378","description":"Rsv mab im 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA0","description":"ICD-CEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC231","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF1","description":"ICD-OBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF0","description":"ICD-EGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87662","description":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA1","description":"ICD-JDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9162","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD1","description":"ICD-FGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA0","description":"ICD-JGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stoma plug or seal_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5081","description":"Stoma plug or seal_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial ankle/ft prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5979","description":"Multi-axial ankle/ft prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA1","description":"ICD-KAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md recertification hha pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0179","description":"Md recertification hha pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF0","description":"ICD-CEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF1","description":"ICD-JECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary compliance study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94750","description":"Pulmonary compliance study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF0","description":"ICD-AGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED1","description":"ICD-AFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj cladribine per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9065","description":"Inj cladribine per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA1","description":"ICD-GFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of salivary gland","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7981","description":"Excision of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC0","description":"ICD-GAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF1","description":"ICD-IDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinal female jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0326","description":"Urinal female jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84132","description":"Assay of serum potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA1","description":"ICD-BGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung perfusion differential","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78597","description":"Lung perfusion differential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9374","description":"Hit hydra 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB0","description":"ICD-FDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF0","description":"ICD-FCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8C","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA1","description":"ICD-BHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB1","description":"ICD-CEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB0","description":"ICD-NBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/chemicl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86970","description":"Rbc pretx incubatj w/chemicl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD1","description":"ICD-CCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1827","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with implantable stimulation lead and external paired stimulation controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE1","description":"ICD-BHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE0","description":"ICD-OFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33944","description":"Prepare donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Car-car bp grft/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33891","description":"Car-car bp grft/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tsi globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84445","description":"Assay of tsi globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8G","description":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF0","description":"ICD-GEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD1","description":"ICD-CEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME1","description":"ICD-JBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC1","description":"ICD-NFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF0","description":"ICD-NJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA0","description":"ICD-NBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF1","description":"ICD-DFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE0","description":"ICD-BHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4187","description":"Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92543","description":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64408","description":"N block inj vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC0","description":"ICD-OCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","description":"HCPCS-Q4373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9091","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11451","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD0","description":"ICD-MKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin tissue procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17999","description":"Skin tissue procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42804","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE0","description":"ICD-JCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Scoliosis dna alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004M","description":"Scoliosis dna alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD0","description":"ICD-MBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF0","description":"ICD-GGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX13","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluciclovine f-18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9588","description":"Fluciclovine f-18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88147","description":"Cytopath c/v automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26641","description":"Treat thumb dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC0","description":"ICD-FDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD1","description":"ICD-CDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22315","description":"Closed tx vert fx w/manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11441","description":"Exc face-mm b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB0","description":"ICD-IAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0122","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neonate crit care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99469","description":"Neonate crit care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB1","description":"ICD-IFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5143","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","description":"HCPCS-Q5143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE1","description":"ICD-DFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Haberman feeder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8265","description":"Haberman feeder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF0","description":"ICD-EALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD1","description":"ICD-PASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of temporal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69535","description":"Remove part of temporal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA0","description":"ICD-GFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC1","description":"ICD-JIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD1","description":"ICD-AEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sever cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64771","description":"Sever cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Close mult vsd w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33676","description":"Close mult vsd w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB0","description":"ICD-NDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD1","description":"ICD-CIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB0","description":"ICD-OCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sex transformation m to f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55970","description":"Sex transformation m to f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0721","description":"HCPCS-E0721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35665","description":"Art byp iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01935","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","description":"CPT-01935","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB1","description":"ICD-KIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81400","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE1","description":"ICD-JFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody absrbj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86310","description":"Heterophile antibody absrbj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32540","description":"Removal of lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA0","description":"ICD-HCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc ot assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0158","description":"Hhc ot assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0407","description":"HCPCS-C0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Denileukin diftitox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9160","description":"Denileukin diftitox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD1","description":"ICD-CBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA1","description":"ICD-JIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF0","description":"ICD-LAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sign lang/oral interpreter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1013","description":"Sign lang/oral interpreter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID0","description":"ICD-FDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF1","description":"ICD-OAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parasymp&symp hrt rate test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95943","description":"Parasymp&symp hrt rate test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB110","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE0","description":"ICD-GFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD1","description":"ICD-FFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB0","description":"ICD-KCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF0","description":"ICD-GEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21310","description":"Closed tx nose fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t4_ n0 w/o prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9085","description":"Onc dx colon t4_ n0 w/o prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE0","description":"ICD-KFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA0","description":"ICD-IBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer >16<= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6207","description":"Contact layer >16<= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3372","description":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA03","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phosphatase forensic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84061","description":"Phosphatase forensic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nerve teasing preparations","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88362","description":"Nerve teasing preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243U","description":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB0","description":"ICD-KADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB1","description":"ICD-GIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA1","description":"ICD-ODIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0523T","description":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE250","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9678","description":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD0","description":"ICD-OAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC1","description":"ICD-NHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC0","description":"ICD-OFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0635T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6598","description":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA0","description":"ICD-JEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB0","description":"ICD-JBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC1","description":"ICD-KELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX33","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB0","description":"ICD-FCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA1","description":"ICD-MBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF1","description":"ICD-NFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1058T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1058T","description":"CPT-1058T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND1","description":"ICD-OAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA0","description":"ICD-AIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9737","description":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC0","description":"ICD-OBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Txmnts 2 phys/qhp by 1 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5020F","description":"Txmnts 2 phys/qhp by 1 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No doc opioid tx 1x at ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9579","description":"No doc opioid tx 1x at ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE1","description":"ICD-FFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID1","description":"ICD-FCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA0","description":"ICD-OIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE1","description":"ICD-EIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD1","description":"ICD-KGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxaliplatin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9263","description":"Oxaliplatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC1","description":"ICD-FDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC0","description":"ICD-JCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11055","description":"Trim skin lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50081","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3C","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD0","description":"ICD-IFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0693","description":"Injection_ cefiderocol_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heparin infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1520","description":"Heparin infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF0","description":"ICD-NAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA0","description":"ICD-FGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX54","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Monitor elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0483","description":"Monitor elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immediate breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19340","description":"Immediate breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC0","description":"ICD-FFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Separate eyelid adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68340","description":"Separate eyelid adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12015","description":"Rpr f/e/e/n/l/m 7.6-12.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD0","description":"ICD-GIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD0","description":"ICD-JCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect metatarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28173","description":"Resect metatarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB0","description":"ICD-GHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27158","description":"Revision of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF1","description":"ICD-CBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6024","description":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyprogesterone caproate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1725","description":"Hydroxyprogesterone caproate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF0","description":"ICD-BAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA1","description":"ICD-ODAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2698","description":"Brachytx_ stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50384","description":"Remove ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF1","description":"ICD-JADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tamoxifen 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0187","description":"Tamoxifen 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB1","description":"ICD-DIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0121","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC1","description":"ICD-OFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC1","description":"ICD-CISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sperm procure init visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4030","description":"Sperm procure init visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE1","description":"ICD-JFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF1","description":"ICD-KEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC0","description":"ICD-OEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF1","description":"ICD-CFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0059U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB1","description":"ICD-FBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC16","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE1","description":"ICD-KHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair fem hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49557","description":"Rerepair fem hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE0","description":"ICD-OHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB1","description":"ICD-EICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF0","description":"ICD-OHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95974","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB0","description":"ICD-NDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8654","description":"Fun stat score hip not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD0","description":"ICD-GIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC112","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE0","description":"ICD-EAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9778","description":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF1","description":"ICD-PJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA0","description":"ICD-FGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC0","description":"ICD-KAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental prophylaxis adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1110","description":"Dental prophylaxis adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC1","description":"ICD-CBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3650","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB1","description":"ICD-GBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF0","description":"ICD-IECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81302","description":"Mecp2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD1","description":"ICD-CABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9838","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Elec hand ind art digits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6880","description":"Elec hand ind art digits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA1","description":"ICD-CAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB0","description":"ICD-CCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33736","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0891","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21175","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4100","description":"Skin substitute_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15600","description":"Delay flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0146U","description":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB1","description":"ICD-IDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lithium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80178","description":"Assay of lithium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80376","description":"Drug/substance nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous rf 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36475","description":"Endovenous rf 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25260","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35321","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/tumr remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45338","description":"Sigmoidoscopy w/tumr remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC1","description":"ICD-LHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28200","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9685","description":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1499","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","description":"HCPCS-M1499","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB0","description":"ICD-MIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX30","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD1","description":"ICD-IGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE0","description":"ICD-GHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vital capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94150","description":"Vital capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5181","description":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB1","description":"ICD-EHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD1","description":"ICD-KEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB34","description":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE1","description":"ICD-BGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA0","description":"ICD-GIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC0","description":"ICD-HARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA0","description":"ICD-BEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of brain tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61545","description":"Excision of brain tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83930","description":"Assay of blood osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA0","description":"ICD-NGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Factor xiii anti-hem factor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7180","description":"Factor xiii anti-hem factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB0","description":"ICD-NKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB0","description":"ICD-CAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE1","description":"ICD-OKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE0","description":"ICD-KDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE1","description":"ICD-MFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED1","description":"ICD-ODED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8E","description":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB0","description":"ICD-AEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC0","description":"ICD-GIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67570","description":"Decompress optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Noninvas resp support talk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4550F","description":"Noninvas resp support talk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB1","description":"ICD-JCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eo elas w/metal jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3710","description":"Eo elas w/metal jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ceftazidime and avibactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0714","description":"Ceftazidime and avibactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay 17- ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83586","description":"Assay 17- ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Melan follow-up complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015F","description":"Melan follow-up complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA0","description":"ICD-NCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC1","description":"ICD-IDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Micafungin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2248","description":"Micafungin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provide inr test mater/equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0249","description":"Provide inr test mater/equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture typing glc/hplc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87143","description":"Culture typing glc/hplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no ahi or rdi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8843","description":"Doc reas no ahi or rdi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA0","description":"ICD-GHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE1","description":"ICD-KHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq sacral augmt bilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201T","description":"Perq sacral augmt bilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo by other than infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0083","description":"Chemo by other than infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","description":"HCPCS-Q4426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA1","description":"ICD-CHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD0","description":"ICD-NGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF1","description":"ICD-MKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE1","description":"ICD-GENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC0","description":"ICD-OCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85705","description":"Thromboplastin inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE0","description":"ICD-JFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Ultrafiltration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0692T","description":"Therapeutic Ultrafiltration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF0","description":"ICD-IDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA1","description":"ICD-NDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC1","description":"ICD-IILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA0","description":"ICD-JACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF1","description":"ICD-FCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0967T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","description":"CPT-0967T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA0","description":"ICD-OHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC41","description":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3809","description":"Whfo w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF1","description":"ICD-BBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB0","description":"ICD-JBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A7021","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","description":"HCPCS-A7021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB0","description":"ICD-CIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME1","description":"ICD-BBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9751","description":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0708","description":"Intraoral - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27703","description":"Reconstruction ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD1","description":"ICD-GGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8710","description":"Pt pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC1","description":"ICD-NBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA0","description":"ICD-AFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC0","description":"ICD-JEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Egd us exam duodenum/jejunum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43259","description":"Egd us exam duodenum/jejunum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD110","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB1","description":"ICD-IBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye photodynamic ther add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67225","description":"Eye photodynamic ther add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy care kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4629","description":"Tracheostomy care kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC0","description":"ICD-OJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB1","description":"ICD-KFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD1","description":"ICD-OFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC0","description":"ICD-CBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73218","description":"MRI upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD115","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose/jaw fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21345","description":"Closed tx nose/jaw fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA21","description":"ICD-3GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB0","description":"ICD-EFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"H2o stat docd normal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2030F","description":"H2o stat docd normal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE0","description":"ICD-GDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81462","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE0","description":"ICD-KHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB1","description":"ICD-AHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD0","description":"ICD-GFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC1","description":"ICD-LFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD0","description":"ICD-DEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC1","description":"ICD-CGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 2 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95861","description":"Muscle test 2 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA11","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enrollment**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0009","description":"Enrollment**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA1","description":"ICD-KHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of csw_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0155","description":"Hhcp-svs of csw_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray head for orthodontia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70350","description":"X-ray head for orthodontia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND0","description":"ICD-KBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF0","description":"ICD-OBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB1","description":"ICD-ADAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD1","description":"ICD-MEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB1","description":"ICD-OHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainable plstic pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4377","description":"Drainable plstic pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC255","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","description":"HCPCS-J0166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rcmnd flw-up 10 yrs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528F","description":"Rcmnd flw-up 10 yrs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27470","description":"Repair of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8566","description":"Pt inelig ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE1","description":"ICD-HBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA26","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triflupromazine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3400","description":"Triflupromazine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB1","description":"ICD-EHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE1","description":"ICD-OKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF0","description":"ICD-FFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF1","description":"ICD-JGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD1","description":"ICD-JGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49616","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB1","description":"ICD-LIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE1","description":"ICD-PARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1053T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1053T","description":"CPT-1053T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF0","description":"ICD-FHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA31","description":"ICD-3KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB0","description":"ICD-KFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474T","description":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE1","description":"ICD-GGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA1","description":"ICD-HBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Online service by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98969","description":"Online service by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user received brief counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2200","description":"Patient identified as an unhealthy alcohol user received brief counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE0","description":"ICD-NBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sterile saline or water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4218","description":"Sterile saline or water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1607","description":"HCPCS-C1607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE1","description":"ICD-OHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33955","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC1","description":"ICD-DISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 4 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90954","description":"Esrd serv 4 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assist living waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2030","description":"Assist living waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF1","description":"ICD-FHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3060F","description":"Pos microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD0","description":"ICD-LBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lactate (ld) (ldh) enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83615","description":"Lactate (ld) (ldh) enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE1","description":"ICD-FGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68700","description":"Repair tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF1","description":"ICD-BBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB1","description":"ICD-FDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE221","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE1","description":"ICD-AGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0003","description":"Lightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No follow up pulm nod norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9347","description":"No follow up pulm nod norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porc 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2644","description":"Dental onlay porc 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF1","description":"ICD-IGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect phalanx of toe tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28175","description":"Resect phalanx of toe tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA1","description":"ICD-BCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB1","description":"ICD-CGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraop oct brst/node spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351T","description":"Intraop oct brst/node spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD1","description":"ICD-CIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD1","description":"ICD-IFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE1","description":"ICD-AFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60270","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0616U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","description":"CPT-0616U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fr frz plasma donor retested","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9060","description":"Fr frz plasma donor retested","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085U","description":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC1","description":"ICD-OBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF0","description":"ICD-CHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC0","description":"ICD-NLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF0","description":"ICD-NKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF0","description":"ICD-AFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Als esophageal intub suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0396","description":"Als esophageal intub suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED0","description":"ICD-ODED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 3 MCG TRS-SUCR","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91308","description":"SARSCOV2 VAC 3 MCG TRS-SUCR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2043","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","description":"HCPCS-A2043","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF1","description":"ICD-MFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF0","description":"ICD-CDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC1","description":"ICD-EEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB1","description":"ICD-NHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1234","description":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF1","description":"ICD-KDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splicing of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50770","description":"Splicing of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64585","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ot re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97004","description":"Ot re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plas shoe insert w ank joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2180","description":"Plas shoe insert w ank joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cefepime hcl for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0692","description":"Cefepime hcl for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID1","description":"ICD-FGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF1","description":"ICD-BDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Order for ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9197","description":"Order for ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF1","description":"ICD-GBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biovance 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4154","description":"Biovance 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA1","description":"ICD-FBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csit perf on low chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8965","description":"Csit perf on low chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID0","description":"ICD-JDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tens suppl 2 lead per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4595","description":"Tens suppl 2 lead per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA1","description":"ICD-NAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD1","description":"ICD-GEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anabolic steroid 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80328","description":"Anabolic steroid 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vit for membrane dissect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67043","description":"Vit for membrane dissect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD0","description":"ICD-ODYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alprostadil for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0270","description":"Alprostadil for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nos vitamin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84591","description":"Assay of nos vitamin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE1","description":"ICD-OCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB0","description":"ICD-LIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD0","description":"ICD-BICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 iobenguane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9582","description":"Iodine i-123 iobenguane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA0","description":"ICD-EFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA1","description":"ICD-NHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE0","description":"ICD-JGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9411","description":"No admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB0","description":"ICD-PIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB0","description":"ICD-NDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE0","description":"ICD-EHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA0","description":"ICD-GHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF1","description":"ICD-PEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC1","description":"ICD-CEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","description":"HCPCS-G0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Care plan hgb docd esa pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514F","description":"Care plan hgb docd esa pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF0","description":"ICD-OBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motion test w/ft press meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96001","description":"Motion test w/ft press meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incomplete endodontic tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3332","description":"Incomplete endodontic tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram both breasts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77056","description":"Mammogram both breasts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94625","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl soft interface_ helmet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8004","description":"Repl soft interface_ helmet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF0","description":"ICD-NBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2468","description":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59840","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF0","description":"ICD-KHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF1","description":"ICD-ODBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90970","description":"Esrd home pt serv p day 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA0","description":"ICD-IDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo mnl lock ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5711","description":"Knee-shin exo mnl lock ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD135","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31267","description":"Endoscopy maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF0","description":"ICD-CDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC1","description":"ICD-DCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD0","description":"ICD-NLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA21","description":"ICD-3AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB0","description":"ICD-KDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54100","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1445","description":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified drugs or biolog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9399","description":"Unclassified drugs or biolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD1","description":"ICD-OALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF0","description":"ICD-ACLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69905","description":"Remove inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC0","description":"ICD-ECBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB0","description":"ICD-FFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC1","description":"ICD-OCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair degenerated kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27418","description":"Repair degenerated kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Novafix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4208","description":"Novafix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prefab post/core + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2954","description":"Prefab post/core + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of fibula epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27732","description":"Repair of fibula epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8919","description":"Mra w/o cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63078","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD1","description":"ICD-CEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0490T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77331","description":"Special radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Band stabilization - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2976","description":"Band stabilization - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF1","description":"ICD-IBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj tendon origin/insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20551","description":"Inj tendon origin/insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9822","description":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA0","description":"ICD-MIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC1","description":"ICD-BEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA0","description":"ICD-BBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle/tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24301","description":"Muscle/tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC0","description":"ICD-OCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA1","description":"ICD-LHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42340","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD231","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33724","description":"Repair venous anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ luspatercept-aamt_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0896","description":"Injection_ luspatercept-aamt_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB1","description":"ICD-LCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA1","description":"ICD-JCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8F","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC0","description":"ICD-CGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE0","description":"ICD-NEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert and remove bone pin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20650","description":"Insert and remove bone pin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA1","description":"ICD-FIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE1","description":"ICD-GEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc app","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44979","description":"Laparoscope proc app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF0","description":"ICD-OKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Detach non-adjus hght armrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0015","description":"Detach non-adjus hght armrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC22","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Devlopment test interpt&rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0451","description":"Devlopment test interpt&rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359U","description":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD0","description":"ICD-KBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF0","description":"ICD-PIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","description":"CPT-01402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA1","description":"ICD-JDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8901","description":"Mra w/o cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA1","description":"ICD-JEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND0","description":"ICD-GGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB0","description":"ICD-NKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9474","description":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB1","description":"ICD-NAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC21","description":"ICD-3CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA1","description":"ICD-MHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I & d vag hematoma non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57023","description":"I & d vag hematoma non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE1","description":"ICD-GBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0637T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"AmnioBind_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4225","description":"AmnioBind_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA0","description":"ICD-CHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453U","description":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB44","description":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE1","description":"ICD-OHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef mod/sever deprs syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3021F","description":"Lvef mod/sever deprs syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA0","description":"ICD-EIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC1","description":"ICD-HIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatoid factor test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86430","description":"Rheumatoid factor test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lev 1 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0380","description":"Lev 1 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA1","description":"ICD-DAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA1","description":"ICD-EGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF1","description":"ICD-NGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE0","description":"ICD-PKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA1","description":"ICD-HBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye suture during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67335","description":"Eye suture during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0403","description":"HCPCS-A0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin/clopidogrel rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4086F","description":"Aspirin/clopidogrel rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD1","description":"ICD-OLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC0","description":"ICD-FHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA1","description":"ICD-MBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD0","description":"ICD-NDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain lower leg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27603","description":"Drain lower leg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB1","description":"ICD-EAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ho frejka cov only pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1610","description":"Ho frejka cov only pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver and spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78215","description":"Liver and spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77080","description":"Dxa bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w/barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5071","description":"Urinary pouch w/barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD0","description":"ICD-DERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE1","description":"ICD-JGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parathyrd planar w/wo subtrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78071","description":"Parathyrd planar w/wo subtrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Twelve volt battery utah/equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7364","description":"Twelve volt battery utah/equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restrata minimatrix_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2026","description":"Restrata minimatrix_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB0","description":"ICD-FFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac output measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93561","description":"Cardiac output measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Poliovirus ipv sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90713","description":"Poliovirus ipv sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"History of or active diagnosis of familial or pure hypercholesterolemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9782","description":"History of or active diagnosis of familial or pure hypercholesterolemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE1","description":"ICD-ODCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE0","description":"ICD-AFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD0","description":"ICD-FIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB0","description":"ICD-PDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0544T","description":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA0","description":"ICD-OAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA1","description":"ICD-FALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9962","description":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB1","description":"ICD-OHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED1","description":"ICD-IFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71046","description":"Radiologic examination_ chest; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lvef <40%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8694","description":"Lvef <40%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC0","description":"ICD-IELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF0","description":"ICD-HFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB0","description":"ICD-KFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD0","description":"ICD-KDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bcg live intravesical vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9031","description":"Bcg live intravesical vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF0","description":"ICD-CCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA1","description":"ICD-HISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410U","description":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX07","description":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC1","description":"ICD-NIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42227","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA0","description":"ICD-EICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Flunisolide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7641","description":"Flunisolide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF1","description":"ICD-MDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell percentage <15%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3497F","description":"Cd4+ cell percentage <15%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Had smoke b/4 anes day surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9645","description":"Had smoke b/4 anes day surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feed supp pump per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4035","description":"Enteral feed supp pump per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA1","description":"ICD-OEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain hand tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26020","description":"Drain hand tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME1","description":"ICD-IEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE1","description":"ICD-KACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA56","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA0","description":"ICD-PJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC35","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD1","description":"ICD-BGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dermal filler inj px/suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9800","description":"Dermal filler inj px/suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE0","description":"ICD-JGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27550","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hard protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8003","description":"Hard protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD1","description":"ICD-KEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003U","description":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB43","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1B","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8011","description":"HCPCS-C8011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD1","description":"ICD-BIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF0","description":"ICD-FFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD0","description":"ICD-JFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB1","description":"ICD-KHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB1","description":"ICD-MDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1219","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD1","description":"ICD-GFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pt category on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9293","description":"No pt category on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF0","description":"ICD-KBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE0","description":"ICD-FHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA0","description":"ICD-FDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93926","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4C","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA0","description":"ICD-PJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB1","description":"ICD-JIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE1","description":"ICD-BGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD0","description":"ICD-KFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5913","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB0","description":"ICD-HHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52317","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1019","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Med list docd in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1159F","description":"Med list docd in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE0","description":"ICD-HDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED0","description":"ICD-BDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31242","description":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD0","description":"ICD-FGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF0","description":"ICD-JILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB1","description":"ICD-BIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Certified nurse midwife mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0064","description":"Certified nurse midwife mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF0","description":"ICD-BGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE1","description":"ICD-BEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB1","description":"ICD-JIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF0","description":"ICD-ICUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC1","description":"ICD-HDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE1","description":"ICD-CCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE1","description":"ICD-FHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC1","description":"ICD-EBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE0","description":"ICD-BEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80344","description":"Antipsychotics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12046","description":"Intmd rpr n-hf/genit20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Smoking cessation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9453","description":"Smoking cessation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 12 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP12","description":"Auto.test pane pricing code_ 12 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID1","description":"ICD-AEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD0","description":"ICD-CBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB0","description":"ICD-KAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64659","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","description":"CPT-64659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC31","description":"ICD-3DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29888","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc lpn/rn obs/asses ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0163","description":"Hhc lpn/rn obs/asses ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC0","description":"ICD-PAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF1","description":"ICD-NGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mirror coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2761","description":"Mirror coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of large breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19318","description":"Reduction of large breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58152","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cryptococcus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86641","description":"Cryptococcus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD0","description":"ICD-PFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB0","description":"ICD-BBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genesis Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4198","description":"Genesis Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB06","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blink reflex test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95933","description":"Blink reflex test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD1","description":"ICD-CBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45520","description":"Treatment of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF0","description":"ICD-MECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD1","description":"ICD-FCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA217","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis ret-oncogene","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3840","description":"Dna analysis ret-oncogene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD0","description":"ICD-OFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE0","description":"ICD-OFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED1","description":"ICD-IGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt tobacco screen rcvd tlk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4004F","description":"Pt tobacco screen rcvd tlk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2126","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF0","description":"ICD-NGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD1","description":"ICD-BBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB0","description":"ICD-CETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB0","description":"ICD-CCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC46","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB0","description":"ICD-FDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99443","description":"Phone e/m phys/qhp 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE0","description":"ICD-CFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove radius head implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24164","description":"Remove radius head implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9084","description":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE1","description":"ICD-DIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB0","description":"ICD-GEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB1","description":"ICD-NBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA1","description":"ICD-HDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8070","description":"Compre dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7525","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24079","description":"Resect arm/elbow tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF0","description":"ICD-KAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Seo mobile arm sup att to wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2626","description":"Seo mobile arm sup att to wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB1","description":"ICD-KAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51595","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC1","description":"ICD-MKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB1","description":"ICD-GDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate pleura w/o imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32554","description":"Aspirate pleura w/o imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ther injection carp tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20526","description":"Ther injection carp tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF0","description":"ICD-NDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mpsv4 vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90733","description":"Mpsv4 vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE1","description":"ICD-MHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hyoscyamine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1980","description":"Hyoscyamine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA0","description":"ICD-IAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plasmaprotein fract_5%_250ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9048","description":"Plasmaprotein fract_5%_250ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA0","description":"ICD-GBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC1","description":"ICD-GAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna sequencing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87153","description":"Dna/rna sequencing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF1","description":"ICD-CAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB1","description":"ICD-OJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF1","description":"ICD-EDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC40","description":"Very High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB0","description":"ICD-NDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC1","description":"ICD-OEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0939T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","description":"CPT-0939T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pralatrexate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9307","description":"Pralatrexate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0243","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay glucose blood quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82947","description":"Assay glucose blood quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4007","description":"Cast sup long arm ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gammagard liquid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1569","description":"Gammagard liquid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33660","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD1","description":"ICD-FADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mobilization of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44139","description":"Mobilization of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC0","description":"ICD-CFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0468","description":"Home ventilator_ dual-function respiratory device_ also performs additional function of cough stimulation_ includes all accessories_ components and supplies for all functions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA12","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF0","description":"ICD-KFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA02","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD0","description":"ICD-OLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC0","description":"ICD-CEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE0","description":"ICD-JGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB1","description":"ICD-FBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA1","description":"ICD-MBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF1","description":"ICD-KDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD1","description":"ICD-OFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC1","description":"ICD-KDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC1","description":"ICD-FDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit nb care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99502","description":"Home visit nb care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA0","description":"ICD-CGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain image w/flow 4 + views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78606","description":"Brain image w/flow 4 + views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA0","description":"ICD-OKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"F2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81240","description":"F2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB1","description":"ICD-PIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA1","description":"ICD-NDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC1","description":"ICD-CAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4288","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","description":"HCPCS-A4288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of chin nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64736","description":"Incision of chin nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE0","description":"ICD-GBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home uterine monitor with or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9001","description":"Home uterine monitor with or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Er- or pr- breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3316F","description":"Er- or pr- breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pd catheter anchor belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4653","description":"Pd catheter anchor belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33903","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE0","description":"ICD-IDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA35","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD0","description":"ICD-KCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD0","description":"ICD-OEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC151","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD0","description":"ICD-MHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea stm ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426T","description":"Insj/rplc nstim apnea stm ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1176","description":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bendamustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9033","description":"Bendamustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99235","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal non-stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59025","description":"Fetal non-stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD1","description":"ICD-HAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44605","description":"Repair of bowel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB0","description":"ICD-JAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54520","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA0","description":"ICD-ECUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE0","description":"ICD-CBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Homedelivered prepared meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5170","description":"Homedelivered prepared meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF0","description":"ICD-NAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4115","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF1","description":"ICD-KFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB0","description":"ICD-ODAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscopy_ with or without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39400","description":"Mediastinoscopy_ with or without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD0","description":"ICD-GGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8I","description":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB1","description":"ICD-FAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esoph imped function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91037","description":"Esoph imped function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF1","description":"ICD-OGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA1","description":"ICD-NAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF0","description":"ICD-JBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47740","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91051","description":"Anesth bladder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41251","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62117","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA0","description":"ICD-BEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95708","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD1","description":"ICD-DGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psy evaluation of records","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90885","description":"Psy evaluation of records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE0","description":"ICD-KEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA0","description":"ICD-GBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE1","description":"ICD-CFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA0","description":"ICD-GBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Facility/Er/Emergency Room","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"450U5","description":"Facility/Er/Emergency Room","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC0","description":"ICD-NEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF0","description":"ICD-GBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC0","description":"ICD-OFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1285","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3A","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC31","description":"ICD-3AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tl201 thallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9505","description":"Tl201 thallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Methsuximide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6054","description":"Methsuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE1","description":"ICD-EGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB0","description":"ICD-BBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB1","description":"ICD-GFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB0","description":"ICD-FFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164T","description":"Remove lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA0","description":"ICD-BDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Meprobamate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6052","description":"Meprobamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD0","description":"ICD-MBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt no ref otolo no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8568","description":"Pt no ref otolo no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50437","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test for porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84106","description":"Test for porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB0","description":"ICD-FEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA0","description":"ICD-CHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF1","description":"ICD-CDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Droperidol/fentanyl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1810","description":"Droperidol/fentanyl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Commissure splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5987","description":"Commissure splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC21","description":"ICD-2IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art pressure waveform analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93050","description":"Art pressure waveform analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00450","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","description":"CPT-00450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50070","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64590","description":"Insrt/redo pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE1","description":"ICD-NEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75658","description":"Artery x-rays arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5260","description":"Hearing aid_ digit_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81353","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC0","description":"ICD-BETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE1","description":"ICD-IAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB0","description":"ICD-NBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE0","description":"ICD-KGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate pleura w/ imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32555","description":"Aspirate pleura w/ imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB0","description":"ICD-FENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted procedure_ intestine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6021","description":"Unlisted procedure_ intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE0","description":"ICD-BGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0629T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8669","description":"Fun stat score ue pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF1","description":"ICD-BDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC235","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF1","description":"ICD-GCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC0","description":"ICD-CGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67015","description":"Release of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES316","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF0","description":"ICD-BGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE1","description":"ICD-BFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Io anal gast n-stim init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95980","description":"Io anal gast n-stim init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Developmental screen w/score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96110","description":"Developmental screen w/score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4772","description":"Blood glucose test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA1","description":"ICD-IFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF0","description":"ICD-KBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5D","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brain flow imaging only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78610","description":"Brain flow imaging only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC0","description":"ICD-FHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE144","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC0","description":"ICD-EFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD0","description":"ICD-PESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD1","description":"ICD-JBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26392","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF0","description":"ICD-GDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2077","description":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15771","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF0","description":"ICD-JEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC1","description":"ICD-FABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87532","description":"Hhv-6 dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"T cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86359","description":"T cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC0","description":"ICD-NAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA0","description":"ICD-OKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC0","description":"ICD-EHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF1","description":"ICD-GHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE0","description":"ICD-AIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC0","description":"ICD-BCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB1","description":"ICD-DIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso r fram soft ant pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0466","description":"Tlso r fram soft ant pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE1","description":"ICD-NBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hematoma/fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10140","description":"Drainage of hematoma/fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA0","description":"ICD-CEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal vaccine admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8864","description":"Pneumococcal vaccine admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC0","description":"ICD-AFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD1","description":"ICD-GHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE0","description":"ICD-IFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair webbed toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28345","description":"Repair webbed toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27641","description":"Partial removal of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42510","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE0","description":"ICD-OFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lat thor/lumb addl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22534","description":"Lat thor/lumb addl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA1","description":"ICD-DHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC0","description":"ICD-IFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87804","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC21","description":"ICD-4JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE0","description":"ICD-JEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCE1","description":"ICD-AGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA0","description":"ICD-GCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB1","description":"ICD-OLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA1","description":"ICD-IEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA0","description":"ICD-FHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA1","description":"ICD-FAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of tonsil abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42700","description":"Drainage of tonsil abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD0","description":"ICD-GCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA0","description":"ICD-LIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9980","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shorten/lengthen thighs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27468","description":"Shorten/lengthen thighs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6023","description":"Collagen dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC0","description":"ICD-LCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD0","description":"ICD-LAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE1","description":"ICD-HIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD0","description":"ICD-FIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA0","description":"ICD-AAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC1","description":"ICD-NFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF1","description":"ICD-NIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB135","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC0","description":"ICD-BGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA0","description":"ICD-GBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD1","description":"ICD-KGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD0","description":"ICD-NAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12016","description":"Rpr fe/e/en/l/m 12.6-20.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0626T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2799","description":"Injection_ risperidone (uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30320","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF0","description":"ICD-MFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB0","description":"ICD-MGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE1","description":"ICD-HESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB1","description":"ICD-HBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE101","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA0","description":"ICD-OADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA0","description":"ICD-FATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC0","description":"ICD-NLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE1","description":"ICD-NIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq coronary mech thrombect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92973","description":"Prq coronary mech thrombect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal fb skin/areolar tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7530","description":"Removal fb skin/areolar tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC1","description":"ICD-OHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC0","description":"ICD-FDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF1","description":"ICD-KISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC1","description":"ICD-FFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE0","description":"ICD-DHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF0","description":"ICD-KELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Silicone gel sheet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6025","description":"Silicone gel sheet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1737","description":"HCPCS-C1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Correction eyelid w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67912","description":"Correction eyelid w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Enter feed supkit syr by day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4034","description":"Enter feed supkit syr by day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC1","description":"ICD-GCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE1","description":"ICD-AHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB0","description":"ICD-OHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24000","description":"Exploratory elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1093T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1093T","description":"CPT-1093T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE0","description":"ICD-MAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64469","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","description":"CPT-64469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD0","description":"ICD-DCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tube_ pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2385","description":"Tube_ pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bcg vaccine intravesical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90586","description":"Bcg vaccine intravesical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD1","description":"ICD-FFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25405","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0956T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","description":"CPT-0956T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","description":"HCPCS-Q5098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33766","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB0","description":"ICD-FFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD217","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA0","description":"ICD-NIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB1","description":"ICD-IGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF1","description":"ICD-FBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA0","description":"ICD-NJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB0","description":"ICD-HFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF1","description":"ICD-KECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal over 10mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0575","description":"Bupren/nal over 10mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF1","description":"ICD-FIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66720","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA0","description":"ICD-MCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients admitted to a skilled nursing facility (snf)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1266","description":"Patients admitted to a skilled nursing facility (snf)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF1","description":"ICD-KGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA1","description":"ICD-NBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF0","description":"ICD-HASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9714","description":"Patient is using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64728","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","description":"CPT-64728","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA1","description":"ICD-LHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF0","description":"ICD-IDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC0","description":"ICD-OIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL52","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78428","description":"Cardiac shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC1","description":"ICD-ABEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC1","description":"ICD-ICLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bl donor search management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38204","description":"Bl donor search management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE1","description":"ICD-OBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE0","description":"ICD-NGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF1","description":"ICD-LDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87494","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","description":"CPT-87494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37226","description":"Fem/popl revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0736","description":"Injection_ clindamycin phosphate_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC1","description":"ICD-FETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB0","description":"ICD-GBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD0","description":"ICD-GIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE1","description":"ICD-FFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"XK GNOTYP XK EXONS 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200U","description":"XK GNOTYP XK EXONS 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92602","description":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE0","description":"ICD-BCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9303","description":"HCPCS-C9303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD1","description":"ICD-JBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine implant_ 74.2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0570","description":"Buprenorphine implant_ 74.2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC0","description":"ICD-PARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54051","description":"Anesth chest surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No rev_ comm_ track biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8885","description":"No rev_ comm_ track biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD0","description":"ICD-KHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9934","description":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA1","description":"ICD-CEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81105","description":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49322","description":"Laparoscopy aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0922T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","description":"CPT-0922T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swing p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5824","description":"Endo knee-shin fluid swing p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB1","description":"ICD-BFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC0","description":"ICD-CDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome banding study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88283","description":"Chromosome banding study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA1","description":"ICD-JGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE0","description":"ICD-IACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB131","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tens four lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0730","description":"Tens four lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA1","description":"ICD-GGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA0","description":"ICD-PESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD0","description":"ICD-KCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC1","description":"ICD-AGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD0","description":"ICD-FEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF1","description":"ICD-NIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF1","description":"ICD-AGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA1","description":"ICD-GHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF1","description":"ICD-FDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone acet inj nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3301","description":"Triamcinolone acet inj nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB1","description":"ICD-NDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier nonheated w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0561","description":"Humidifier nonheated w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB1","description":"ICD-EGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF0","description":"ICD-AAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF0","description":"ICD-AALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD0","description":"ICD-CEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA0","description":"ICD-CIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB1","description":"ICD-JEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA1","description":"ICD-CAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28190","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Npo (nothing-mouth) ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6020F","description":"Npo (nothing-mouth) ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice respite care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2044","description":"Hospice respite care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE1","description":"ICD-BICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9375","description":"Hit hydra 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID1","description":"ICD-KGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC0","description":"ICD-EGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC1","description":"ICD-MDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC0","description":"ICD-BBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA1","description":"ICD-CDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC1","description":"ICD-ODFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB0","description":"ICD-MILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE1","description":"ICD-OAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27659","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB46","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC1","description":"ICD-GBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB0","description":"ICD-CDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC1","description":"ICD-NIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375U","description":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ofatumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9302","description":"Ofatumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA0","description":"ICD-EBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE0","description":"ICD-FHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect forarm/wrist tum 3cm>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25078","description":"Resect forarm/wrist tum 3cm>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB1","description":"ICD-OFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Apicoect/perirad surg anter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3410","description":"Apicoect/perirad surg anter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF0","description":"ICD-CHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB05","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB0","description":"ICD-PLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB0","description":"ICD-KETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF1","description":"ICD-MDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv reactj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86078","description":"Phys blood bank serv reactj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF1","description":"ICD-FGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4035","description":"Thoracic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC1","description":"ICD-JCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5257","description":"Hearing aid_ digit_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE1","description":"ICD-PKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum deep <5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27328","description":"Exc thigh/knee tum deep <5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9014","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx infiltrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32607","description":"Thoracoscopy w/bx infiltrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8442","description":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF0","description":"ICD-CAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC0","description":"ICD-ACUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dialyzer_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4690","description":"Dialyzer_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid specific gravity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84315","description":"Body fluid specific gravity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj gadoterate meglumi 0.1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9575","description":"Inj gadoterate meglumi 0.1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD1","description":"ICD-FATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA0","description":"ICD-HGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE0","description":"ICD-IGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD0","description":"ICD-BEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Legionella micdadei ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87277","description":"Legionella micdadei ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-61715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","description":"CPT-61715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD0","description":"ICD-GEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF1","description":"ICD-NDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB0","description":"ICD-BCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB0","description":"ICD-OFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ascorbic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82180","description":"Assay of ascorbic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay prostate phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84066","description":"Assay prostate phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA1","description":"ICD-DIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES246","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE1","description":"ICD-CFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tymp memb motion examd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2035F","description":"Tymp memb motion examd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Organic acid single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83921","description":"Organic acid single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA1","description":"ICD-IBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Post chmbr intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2632","description":"Post chmbr intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF1","description":"ICD-LBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB1","description":"ICD-FCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE0","description":"ICD-CCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD0","description":"ICD-JECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44392","description":"Colonoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Var vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90716","description":"Var vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheo-esophagoplasty cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43314","description":"Tracheo-esophagoplasty cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0106","description":"HCPCS-C0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA INFLUENZA A/B EACH","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87400","description":"IAAD IA INFLUENZA A/B EACH","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92250","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA1","description":"ICD-NGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vis 20/40/> w/in 90 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4175F","description":"Vis 20/40/> w/in 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87515","description":"Hepatitis b dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB1","description":"ICD-JACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE0","description":"ICD-IABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB0","description":"ICD-EEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB1","description":"ICD-KCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splint digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8450","description":"Splint digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME0","description":"ICD-JEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trauma respons w/hosp criti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0390","description":"Trauma respons w/hosp criti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE0","description":"ICD-CGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99386","description":"Prev visit new age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo anti-neopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96401","description":"Chemo anti-neopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF0","description":"ICD-NIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA1","description":"ICD-HIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA1","description":"ICD-OIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8A","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF0","description":"ICD-PGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE0","description":"ICD-FCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43352","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC1","description":"ICD-JGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8G","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA1","description":"ICD-ADIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62280","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC0","description":"ICD-OGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA1","description":"ICD-AFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40830","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise/rmv pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64595","description":"Revise/rmv pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB1","description":"ICD-LGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE1","description":"ICD-IBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB1","description":"ICD-EFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","description":"HCPCS-J9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF0","description":"ICD-NITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD0","description":"ICD-PEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC1","description":"ICD-LFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE1","description":"ICD-MACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2159","description":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA0","description":"ICD-CDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of forehead wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15824","description":"Removal of forehead wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triptorelin_ extended-release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3316","description":"Injection_ triptorelin_ extended-release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED1","description":"ICD-KAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA0","description":"ICD-GBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hip disart canadian sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5331","description":"Hip disart canadian sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE1","description":"ICD-KFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1033T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1033T","description":"CPT-1033T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O2 flow reg pos inspir press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1352","description":"O2 flow reg pos inspir press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE1","description":"ICD-PDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC1","description":"ICD-NGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75827","description":"Vein x-ray chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC1","description":"ICD-JHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB0","description":"ICD-ADLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF0","description":"ICD-CDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dorsi & plantar flex ass/res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2220","description":"Dorsi & plantar flex ass/res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE201","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB1","description":"ICD-OGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF0","description":"ICD-DASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE1","description":"ICD-OEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF0","description":"ICD-CAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA1","description":"ICD-CIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC0","description":"ICD-GEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ascent_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4213","description":"Ascent_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB1","description":"ICD-KGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF1","description":"ICD-FECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plas sing free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2037","description":"Kafo plas sing free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28108","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bed pan fracture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0276","description":"Bed pan fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC1","description":"ICD-ECCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33780","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coude tip urinary catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4352","description":"Coude tip urinary catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC31","description":"ICD-2GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test socket symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5618","description":"Test socket symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal Endo Surg; Balln Dilat Eust T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9745","description":"Nasal Endo Surg; Balln Dilat Eust T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eeg awake and asleep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95819","description":"Eeg awake and asleep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA1","description":"ICD-LESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76001","description":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD0","description":"ICD-MEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE1","description":"ICD-OEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2c9 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81227","description":"Cyp2c9 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC0","description":"ICD-AHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1837","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","description":"HCPCS-J1837","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD254","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47560","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD0","description":"ICD-NBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0138U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB1","description":"ICD-BBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF0","description":"ICD-MHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2510","description":"Penicillin g procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF1","description":"ICD-BINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB0","description":"ICD-KCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF1","description":"ICD-OLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1184","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA0","description":"ICD-FIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC1","description":"ICD-PARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB0","description":"ICD-GDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drsg <=16 sq in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6209","description":"Foam drsg <=16 sq in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE0","description":"ICD-MDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD1","description":"ICD-AIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352U","description":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB0","description":"ICD-FGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 125","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86304","description":"Immunoassay tumor ca 125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor intestine/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44720","description":"Prep donor intestine/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70486","description":"Ct maxillofacial w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0080","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA51","description":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ trans atherec_rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1724","description":"Cath_ trans atherec_rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Office emergency care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99058","description":"Office emergency care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8D","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD1","description":"ICD-NGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microprocessor control uplmb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6882","description":"Microprocessor control uplmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Metabolic panel total ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80048","description":"Metabolic panel total ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA0","description":"ICD-JHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF1","description":"ICD-KHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE1","description":"ICD-MGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF1","description":"ICD-NCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86037","description":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA13","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC0","description":"ICD-OKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB0","description":"ICD-HISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC11","description":"ICD-3GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee control condylar pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2810","description":"Knee control condylar pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00796","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","description":"CPT-00796","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2D","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF1","description":"ICD-NHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB1","description":"ICD-LGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA1","description":"ICD-NHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8999","description":"Motor speech current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61156","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6254","description":"Absorpt drg <=16 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF1","description":"ICD-MJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA0","description":"ICD-DEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD1","description":"ICD-IHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC0","description":"ICD-GDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE0","description":"ICD-JCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0478U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","description":"CPT-0478U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17286","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD0","description":"ICD-FFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB0","description":"ICD-HGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB1","description":"ICD-NIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87495","description":"Cytomeg dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD1","description":"ICD-KDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63704","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF0","description":"ICD-MIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA0","description":"ICD-IHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0486T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE1","description":"ICD-IFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB1","description":"ICD-OFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC0","description":"ICD-EHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC0","description":"ICD-EAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB0","description":"ICD-GIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44955","description":"Appendectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC1","description":"ICD-BDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Masters two step","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3904","description":"Masters two step","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE0","description":"ICD-HDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC1","description":"ICD-BIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Embolization protect syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1884","description":"Embolization protect syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF0","description":"ICD-GIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial exam involved joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2004F","description":"Initial exam involved joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407U","description":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv xmatch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86077","description":"Phys blood bank serv xmatch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","description":"CPT-37274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA21","description":"ICD-4IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1022T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","description":"CPT-1022T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA1","description":"ICD-KHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF1","description":"ICD-HHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88028","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF1","description":"ICD-MEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD0","description":"ICD-NLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6012","description":"Endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6521","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA1","description":"ICD-OGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD1","description":"ICD-GHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No conformal radn thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4182F","description":"No conformal radn thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB1","description":"ICD-GIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD0","description":"ICD-KDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB0","description":"ICD-HHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF0","description":"ICD-MCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE1","description":"ICD-FEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA0","description":"ICD-ODSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE214","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF1","description":"ICD-KDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD0","description":"ICD-BCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE1","description":"ICD-BEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF1","description":"ICD-GEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA256","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD0","description":"ICD-CEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF1","description":"ICD-ABDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma stent/stud/bttn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7524","description":"Tracheostoma stent/stud/bttn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB0","description":"ICD-OKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB1","description":"ICD-OHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01444","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","description":"CPT-01444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonstnd lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0581","description":"Nonstnd lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm aud input receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5285","description":"Ald fm/dm aud input receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC11","description":"ICD-3CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE0","description":"ICD-LEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31535","description":"Laryngoscopy w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB0","description":"ICD-KCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE1","description":"ICD-GHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD0","description":"ICD-FITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE0","description":"ICD-BITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53420","description":"Reconstruct urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA0","description":"ICD-GIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mass spectrometry qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83789","description":"Mass spectrometry qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD0","description":"ICD-NDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES341","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE1","description":"ICD-LGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB1","description":"ICD-HASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB1","description":"ICD-PDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release finger contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26525","description":"Release finger contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB111","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC0","description":"ICD-GIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF0","description":"ICD-BAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC1","description":"ICD-GDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair special seat heig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1296","description":"Wheelchair special seat heig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB1","description":"ICD-FDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA0","description":"ICD-FEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscop po debrid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2342","description":"Nasal endoscop po debrid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB1","description":"ICD-JEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tympanometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92567","description":"Tympanometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF0","description":"ICD-BDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide sol_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9529","description":"I131 iodide sol_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood Component Or Product Not Otherwise Classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9099","description":"Blood Component Or Product Not Otherwise Classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB1","description":"ICD-FIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB1","description":"ICD-ODKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plastic pediatric size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2035","description":"Kafo plastic pediatric size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9046","description":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8G","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2201","description":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10009","description":"Fine needle aspiration biopsy_ including CT guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe_ perc lumb disc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2614","description":"Probe_ perc lumb disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD1","description":"ICD-KFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Long tongue stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2265","description":"Long tongue stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9284","description":"Non-electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo partial nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50543","description":"Laparo partial nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE0","description":"ICD-LERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73600","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Debridement & contouring","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6102","description":"Debridement & contouring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF1","description":"ICD-KIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA1","description":"ICD-IELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC1","description":"ICD-JDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC0","description":"ICD-JBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC1","description":"ICD-BDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID1","description":"ICD-BDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"FMRI brain by tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70554","description":"FMRI brain by tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD0","description":"ICD-MLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urinary leg or abdomen bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4358","description":"Urinary leg or abdomen bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC0","description":"ICD-GEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF0","description":"ICD-JCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF1","description":"ICD-BIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43887","description":"Remove gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal over 12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2314","description":"Lens sphcyl trifocal over 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF1","description":"ICD-CBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7460","description":"Rem nonodonto cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB212","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC1","description":"ICD-NHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB1","description":"ICD-GGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine/urea-n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84540","description":"Assay of urine/urea-n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF1","description":"ICD-GEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA1","description":"ICD-OKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX54","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61889","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81120","description":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD0","description":"ICD-GEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB1","description":"ICD-GHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low risk for retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3072F","description":"Low risk for retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1036T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1036T","description":"CPT-1036T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE0","description":"ICD-BFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73010","description":"X-ray exam of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB0","description":"ICD-JBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE1","description":"ICD-BDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dental other tmj films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0321","description":"Dental other tmj films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54060","description":"Excision of penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB0","description":"ICD-DFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_hdr ir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1717","description":"Brachytx_ non-str_hdr ir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA1","description":"ICD-KGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3B","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD0","description":"ICD-MJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Place cath vertebral art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36226","description":"Place cath vertebral art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60545","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","description":"CPT-01500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF0","description":"ICD-KFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services used by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9709","description":"Hospice services used by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE1","description":"ICD-ICDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF1","description":"ICD-CDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy orchiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54690","description":"Laparoscopy orchiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31511","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical path gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88300","description":"Surgical path gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL42","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34490","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF1","description":"ICD-EBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1030","description":"Rn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27330","description":"Biopsy knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF0","description":"ICD-FBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","description":"CPT-91124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD0","description":"ICD-FHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB0","description":"ICD-JHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA1","description":"ICD-BIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC1","description":"ICD-JGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE0","description":"ICD-BDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE1","description":"ICD-OIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB0","description":"ICD-CACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9944","description":"Occlusal guard - hard appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37236","description":"Open/perq place stent 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interim abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6051","description":"Interim abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC0","description":"ICD-DFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC0","description":"ICD-NATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC1","description":"ICD-AEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37297","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","description":"CPT-37297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00560","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","description":"CPT-00560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1128","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE1","description":"ICD-ACEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special stains group 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88313","description":"Special stains group 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjv thxpyrxd/rcvd colon ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4180F","description":"Adjv thxpyrxd/rcvd colon ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temp anchorage dev w/o flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7294","description":"Temp anchorage dev w/o flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD1","description":"ICD-GCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC1","description":"ICD-JBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5132","description":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD150","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61605","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0589T","description":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alginate dressing > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6198","description":"Alginate dressing > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD1","description":"ICD-GBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE0","description":"ICD-FFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bed accessory brd/tbl/supprt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0315","description":"Bed accessory brd/tbl/supprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC1","description":"ICD-JEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC0","description":"ICD-KEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath cell enhance tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88112","description":"Cytopath cell enhance tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9974","description":"Intrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE1","description":"ICD-KDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF0","description":"ICD-BFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/urinary repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58267","description":"Vag hyst w/urinary repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1B","description":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB0","description":"ICD-GIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE1","description":"ICD-MLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC0","description":"ICD-GDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB1","description":"ICD-PFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0492","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate/inj ganglion cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20612","description":"Aspirate/inj ganglion cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF1","description":"ICD-JIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD0","description":"ICD-NFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4029","description":"Cast sup long leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42972","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB1","description":"ICD-CGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-elastic extremity binder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4465","description":"Non-elastic extremity binder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA0","description":"ICD-CEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB0","description":"ICD-CECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients receiving rrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1199","description":"Patients receiving rrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ travoprost_ intracameral implant_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7355","description":"Injection_ travoprost_ intracameral implant_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC1","description":"ICD-ODWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC1","description":"ICD-CBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal invas px w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59897","description":"Fetal invas px w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq cardiac angioplast 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92920","description":"Prq cardiac angioplast 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0500U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","description":"CPT-0500U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD1","description":"ICD-BITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65125","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD0","description":"ICD-CESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX13","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9785","description":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC0","description":"ICD-OKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID0","description":"ICD-CCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF1","description":"ICD-LCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND0","description":"ICD-BDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD0","description":"ICD-NCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC240","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE0","description":"ICD-PHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0478T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF1","description":"ICD-BEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB0","description":"ICD-OBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD0","description":"ICD-JCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Iop measurement not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1226","description":"Iop measurement not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB06","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7512","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis modification","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5875","description":"Prosthesis modification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE0","description":"ICD-NDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia with hypothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99116","description":"Anesthesia with hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC0","description":"ICD-ACHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF0","description":"ICD-CCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Small animal inoculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87003","description":"Small animal inoculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9719","description":"Patient is not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in whee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB0","description":"ICD-MGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Graft hand or finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26416","description":"Graft hand or finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","description":"CPT-01740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD0","description":"ICD-OHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB0","description":"ICD-OLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA17","description":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD1","description":"ICD-MKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0102","description":"CDT-D0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mucus trap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8210","description":"Mucus trap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD1","description":"ICD-FDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC11","description":"ICD-2JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA0","description":"ICD-CIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Saquinavir_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0140","description":"Saquinavir_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE1","description":"ICD-GGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE1","description":"ICD-BEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD141","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1101","description":"HCPCS-A1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31820","description":"Closure of windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD0","description":"ICD-KEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","description":"HCPCS-Q4385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26478","description":"Lengthening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD1","description":"ICD-EITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC1","description":"ICD-HEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC0","description":"ICD-FGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"XCellerate_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4234","description":"XCellerate_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abut support crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6094","description":"Abut support crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier heated used w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0562","description":"Humidifier heated used w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC1","description":"ICD-ABTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA0","description":"ICD-PGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA1","description":"ICD-MICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation for wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9156","description":"Evaluation for wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD0","description":"ICD-AELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC1","description":"ICD-ECTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE0","description":"ICD-KBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD1","description":"ICD-LIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients on immune checkpoint inhibitor therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1180","description":"Patients on immune checkpoint inhibitor therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3C","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95834","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF0","description":"ICD-GDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB0","description":"ICD-KFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 3 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7297","description":"Levonorgestrel iu 52mg 3 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF1","description":"ICD-EEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB0","description":"ICD-NKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF0","description":"ICD-CIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide cap_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9517","description":"I131 iodide cap_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB1","description":"ICD-KFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF0","description":"ICD-KDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc prosth delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33886","description":"Endovasc prosth delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB1","description":"ICD-CHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62223","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID1","description":"ICD-JEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA0","description":"ICD-AACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC0","description":"ICD-PLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD141","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21421","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD1","description":"ICD-AILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1152","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA1","description":"ICD-BDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Co57 cyano","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9559","description":"Co57 cyano","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA0","description":"ICD-CCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01464","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","description":"CPT-01464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF1","description":"ICD-GCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00794","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","description":"CPT-00794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC1","description":"ICD-NGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE1","description":"ICD-CIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE0","description":"ICD-KHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30310","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE0","description":"ICD-GERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26418","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ring flange plastic/leather","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1100","description":"Ring flange plastic/leather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC101","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC42","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA1","description":"ICD-KHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE201","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF0","description":"ICD-OFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE0","description":"ICD-PHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB1","description":"ICD-OAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transferase (ast) (sgot)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84450","description":"Transferase (ast) (sgot)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin b12 injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3420","description":"Vitamin b12 injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC0","description":"ICD-MDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF1","description":"ICD-PGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag and followup no rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9550","description":"Abd imag and followup no rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF0","description":"ICD-GHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE146","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1602","description":"HCPCS-A1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA224","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vabra aspirator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4480","description":"Vabra aspirator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB1","description":"ICD-NAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB1","description":"ICD-KANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE1","description":"ICD-KHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD1","description":"ICD-JIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE0","description":"ICD-JCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF0","description":"ICD-NFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tilt table locking hip sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5270","description":"Tilt table locking hip sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD0","description":"ICD-BHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1168","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1404","description":"HCPCS-C1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl pt no el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8665","description":"Fun stat score shdl pt no el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32310","description":"Removal of chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB1","description":"ICD-AHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of total replacement heart system (artificial heart)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33928","description":"Removal and replacement of total replacement heart system (artificial heart)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE1","description":"ICD-OFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE1","description":"ICD-KBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA0","description":"ICD-EAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA1","description":"ICD-PAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acp discuss-no dscnmkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1124F","description":"Acp discuss-no dscnmkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB0","description":"ICD-KBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF0","description":"ICD-IBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ granisetron_ extended-release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1627","description":"Injection_ granisetron_ extended-release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31230","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL24","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB0","description":"ICD-FCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Serum clotting time tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4771","description":"Serum clotting time tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4003","description":"Cast sup shoulder cast plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen concentrator_ dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1391","description":"Oxygen concentrator_ dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2391","description":"Solid caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD0","description":"ICD-NKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA1","description":"ICD-OGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74742","description":"X-ray fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7983","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81404","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93573","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29345","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33813","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB1","description":"ICD-JGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89290","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB1","description":"ICD-MGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD0","description":"ICD-LDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68520","description":"Removal of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE1","description":"ICD-CCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB1","description":"ICD-OCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD0","description":"ICD-PEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21125","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA0","description":"ICD-GBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9140","description":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD0","description":"ICD-OHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB1","description":"ICD-BFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA0","description":"ICD-LBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID0","description":"ICD-IFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27501","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pet image skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78812","description":"Pet image skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD1","description":"ICD-GAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD0","description":"ICD-GBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9243","description":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB0","description":"ICD-OFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9938","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA1","description":"ICD-GELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot s total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85305","description":"Clot inhibit prot s total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37266","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","description":"CPT-37266","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD1","description":"ICD-NEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0689","description":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0611U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","description":"CPT-0611U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol compressor adjust pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0572","description":"Aerosol compressor adjust pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg congen hernia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2400","description":"Fetal surg congen hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE1","description":"ICD-IFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44212","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA1","description":"ICD-GENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreatic duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48148","description":"Removal of pancreatic duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admin pneumococcal vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0009","description":"Admin pneumococcal vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep addl 100 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15003","description":"Wound prep addl 100 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27532","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC1","description":"ICD-CBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47760","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/3-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34803","description":"Endovas aaa repr w/3-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9023","description":"Injection_ avelumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB1","description":"ICD-FHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27307","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC0","description":"ICD-KDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC0","description":"ICD-NLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26562","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME0","description":"ICD-CGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology colon mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81525","description":"Oncology colon mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC135","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA1","description":"ICD-FDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD1","description":"ICD-MGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93897","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","description":"CPT-93897","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB0","description":"ICD-OAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit high risk/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9381","description":"Hit high risk/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC1","description":"ICD-BAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nepuitant 300 mg and palonosetron 0.5 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9978","description":"Nepuitant 300 mg and palonosetron 0.5 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB0","description":"ICD-KHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC0","description":"ICD-KHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patch_ lidocaine/tetracaine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9285","description":"Patch_ lidocaine/tetracaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9379","description":"Hit noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC1","description":"ICD-BANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA1","description":"ICD-GDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA0","description":"ICD-FBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE1","description":"ICD-OABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF0","description":"ICD-NJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 gene full seq analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81317","description":"Pms2 gene full seq analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No hepc rna after med no rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9211","description":"No hepc rna after med no rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Locm >= 400 mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9951","description":"Locm >= 400 mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep c therapy started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9206","description":"Hep c therapy started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE1","description":"ICD-KENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF1","description":"ICD-FIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA0","description":"ICD-KIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF1","description":"ICD-OINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD0","description":"ICD-OCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB0","description":"ICD-LCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4281","description":"Replacement breastpump tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF0","description":"ICD-LIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB1","description":"ICD-BGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA112","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB0","description":"ICD-EBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB1","description":"ICD-NEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA0","description":"ICD-FEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC0","description":"ICD-OJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Harvesting of donor multivis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2055","description":"Harvesting of donor multivis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB145","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99255","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB0","description":"ICD-OFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2209","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF1","description":"ICD-GEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cysto laser tx ureteral calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2070","description":"Cysto laser tx ureteral calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA1","description":"ICD-KDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC0","description":"ICD-OLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 2vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72070","description":"X-ray exam thorac spine 2vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB21","description":"ICD-2HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC0","description":"ICD-GDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98926","description":"Osteopath manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE0","description":"ICD-DBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB1","description":"ICD-HFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE1","description":"ICD-KBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77336","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9246","description":"No med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace part denture teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5640","description":"Replace part denture teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE0","description":"ICD-CGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE0","description":"ICD-GGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47130","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD0","description":"ICD-MKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB1","description":"ICD-BANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA1","description":"ICD-JGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE0","description":"ICD-GFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF1","description":"ICD-MDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD0","description":"ICD-KCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB1","description":"ICD-BCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB0","description":"ICD-DGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ othr than cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1733","description":"Cath_ ep_ othr than cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decalcification procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0475","description":"Decalcification procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53452","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA1","description":"ICD-LHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cor artery disease mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81493","description":"Cor artery disease mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA1","description":"ICD-MBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB1","description":"ICD-GGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit tocolysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9349","description":"Hit tocolysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB1","description":"ICD-EHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove digit nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64776","description":"Remove digit nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE1","description":"ICD-HGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF1","description":"ICD-MIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0497U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","description":"CPT-0497U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF1","description":"ICD-OKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA0","description":"ICD-MBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX11","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC1","description":"ICD-ICMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58920","description":"Partial removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB0","description":"ICD-JDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA1","description":"ICD-OAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB0","description":"ICD-HDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC0","description":"ICD-AAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC1","description":"ICD-FCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA0","description":"ICD-CBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC0","description":"ICD-EFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD1","description":"ICD-AHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC1","description":"ICD-JHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB1","description":"ICD-BIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE211","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL23","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recement cast or prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2915","description":"Recement cast or prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC0","description":"ICD-BCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72147","description":"MRI chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Culture othr specimn aerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87070","description":"Culture othr specimn aerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1301","description":"CDT-D1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0305","description":"HCPCS-C0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD0","description":"ICD-GDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar derotation pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1240","description":"Lumbar derotation pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED0","description":"ICD-IBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33016","description":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB1","description":"ICD-NJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB0","description":"ICD-IATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC1","description":"ICD-AGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE1","description":"ICD-BANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bis xtracell fluid analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93702","description":"Bis xtracell fluid analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD1","description":"ICD-BHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8F","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76983","description":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE0","description":"ICD-CIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB0","description":"ICD-FAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE1","description":"ICD-CAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum dep 1.5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28041","description":"Exc foot/toe tum dep 1.5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC0","description":"ICD-JGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal axial rotation u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5982","description":"Exoskeletal axial rotation u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC1","description":"ICD-CFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74246","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare sperm duct x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55300","description":"Prepare sperm duct x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF1","description":"ICD-GDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive_ liquid or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4364","description":"Adhesive_ liquid or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB1","description":"ICD-NLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76942","description":"Echo guide for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fuse liver duct & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47802","description":"Fuse liver duct & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD1","description":"ICD-PBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc chronic addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92944","description":"Prq card revasc chronic addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB1","description":"ICD-KDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA1","description":"ICD-LCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bio mtrls to aid soft/os reg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4265","description":"Bio mtrls to aid soft/os reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA0","description":"ICD-BIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26420","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA1","description":"ICD-JHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB0","description":"ICD-GHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB24","description":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD1","description":"ICD-KDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC0","description":"ICD-OLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD0","description":"ICD-ODMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1804","description":"HCPCS-A1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB0","description":"ICD-CFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD0","description":"ICD-KATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA0","description":"ICD-GGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4B","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE134","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC0","description":"ICD-OAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA1","description":"ICD-OKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC1","description":"ICD-FDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0082","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE1","description":"ICD-EILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB0","description":"ICD-KIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF1","description":"ICD-HBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acesso_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4311","description":"Acesso_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF1","description":"ICD-JCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin >500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96922","description":"Laser tx skin >500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB0","description":"ICD-GGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD0","description":"ICD-BHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE0","description":"ICD-OIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC0","description":"ICD-JAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD146","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB1","description":"ICD-LBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0492U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","description":"CPT-0492U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycophenolic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7518","description":"Mycophenolic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC1","description":"ICD-OCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Car seat/bed test + 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94781","description":"Car seat/bed test + 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB1","description":"ICD-FHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endometr ablate thermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58353","description":"Endometr ablate thermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add instep extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3570","description":"O shoe add instep extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB1","description":"ICD-FBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65093","description":"Revise eye with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC1","description":"ICD-JCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE1","description":"ICD-GIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX36","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA215","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4314","description":"Cath w/drainage 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy test drug/bug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95024","description":"Icut allergy test drug/bug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC11","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD1","description":"ICD-GDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0734","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37262","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","description":"CPT-37262","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE0","description":"ICD-PJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA1","description":"ICD-BIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF0","description":"ICD-OJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC0","description":"ICD-FDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA53","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA254","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA06","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood culture for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87040","description":"Blood culture for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF0","description":"ICD-IAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD1","description":"ICD-MJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgimend_ neonatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9360","description":"Surgimend_ neonatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28740","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413U","description":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE1","description":"ICD-ICHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF0","description":"ICD-CEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mohs addl stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17314","description":"Mohs addl stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF0","description":"ICD-GEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD0","description":"ICD-IBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA0","description":"ICD-NIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51705","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA1","description":"ICD-NJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB0","description":"ICD-MBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA0","description":"ICD-AAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD1","description":"ICD-GHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE1","description":"ICD-EDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61558","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0469","description":"Tlso rig fram pelvic pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2182","description":"Injection_ mepolizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gefitinib oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8565","description":"Gefitinib oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC1","description":"ICD-BEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF1","description":"ICD-KGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB136","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA0","description":"ICD-DDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC0","description":"ICD-CBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE1","description":"ICD-OEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC53","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD0","description":"ICD-FGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64713","description":"Revision of arm nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA0","description":"ICD-OFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD0","description":"ICD-NGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB1","description":"ICD-GAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE0","description":"ICD-GEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spinal disk surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63035","description":"Spinal disk surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC0","description":"ICD-KIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinsert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65155","description":"Reinsert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA42","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA1","description":"ICD-CHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0767T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB51","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA1","description":"ICD-OKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE0","description":"ICD-FAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC0","description":"ICD-OHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF1","description":"ICD-JBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD0","description":"ICD-CFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC1","description":"ICD-MHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE240","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB1","description":"ICD-CGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID1","description":"ICD-NGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB1","description":"ICD-OICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of impacted wax md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0268","description":"Removal of impacted wax md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB1","description":"ICD-LARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 10 gm lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4185","description":"Parenteral sol 10 gm lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC1","description":"ICD-JGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC212","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF1","description":"ICD-BAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0634U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0634U","description":"CPT-0634U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML31","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA1","description":"ICD-OAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD1","description":"ICD-NAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pre-surg eye measures docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3073F","description":"Pre-surg eye measures docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Toc dur aneth to icu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9657","description":"Toc dur aneth to icu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6780","description":"Crown 3/4 high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-75577","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","description":"CPT-75577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81220","description":"Cftr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD1","description":"ICD-GECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA03","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC0","description":"ICD-CGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB0","description":"ICD-OBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81437","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE204","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD1","description":"ICD-GDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE1","description":"ICD-CFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28250","description":"Revision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43180","description":"Esophagoscopy rigid trnso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insj iris prosth sec io lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0618T","description":"Insj iris prosth sec io lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA1","description":"ICD-OCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ciprofloxacin iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0744","description":"Ciprofloxacin iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA1","description":"ICD-FBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD1","description":"ICD-DGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1080T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1080T","description":"CPT-1080T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA0","description":"ICD-JCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE124","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA1","description":"ICD-BAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB1","description":"ICD-NLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insulin dispos pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5570","description":"Insulin dispos pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27310","description":"Exploration of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 150-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9959","description":"Hocm 150-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 probe&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87538","description":"Hiv-2 probe&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81517","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [HA]_ procollagen III amino terminal peptide [PIIINP]_ tissue inhibitor of metalloproteinase 1 [TIMP-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD0","description":"ICD-BBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF0","description":"ICD-OKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD1","description":"ICD-CDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC0","description":"ICD-OKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37145","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bk molded distal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5668","description":"Bk molded distal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1304","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB1","description":"ICD-CANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27259","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rsk fx ref w/n 24 hrs xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5100F","description":"Rsk fx ref w/n 24 hrs xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC0","description":"ICD-HIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26735","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alanine amino (alt) (sgpt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84460","description":"Alanine amino (alt) (sgpt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB1","description":"ICD-HBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA0","description":"ICD-BFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Telemonitoring/home per mnth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9110","description":"Telemonitoring/home per mnth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2134","description":"Kafo fem fx cast semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA0","description":"ICD-EEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cosyntropin cortrosyn inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0834","description":"Cosyntropin cortrosyn inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE0","description":"ICD-IHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC0","description":"ICD-KFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Regional block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9211","description":"Regional block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86830","description":"Hla class i phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2147","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA1","description":"ICD-DIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam abdominl aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75625","description":"Contrast exam abdominl aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB1","description":"ICD-BHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA0","description":"ICD-KHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype infect agent drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87900","description":"Phenotype infect agent drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50780","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417T","description":"Prgrmg eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB0","description":"ICD-GEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE0","description":"ICD-NDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF1","description":"ICD-AGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB1","description":"ICD-IATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","description":"CPT-01215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gjb2 gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81253","description":"Gjb2 gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56810","description":"Repair of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gene test alpha-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3845","description":"Gene test alpha-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC0","description":"ICD-KCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED1","description":"ICD-OGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3B","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA0","description":"ICD-DBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF1","description":"ICD-IHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2155","description":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/90d mrs 0-2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9646","description":"Pt w/90d mrs 0-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0047U","description":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF0","description":"ICD-OEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC1","description":"ICD-HHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB1","description":"ICD-CFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095U","description":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Washed red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9022","description":"Washed red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF1","description":"ICD-KHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID0","description":"ICD-EFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC1","description":"ICD-ODCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB0","description":"ICD-BFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA1","description":"ICD-LFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC255","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD1","description":"ICD-FFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE0","description":"ICD-OJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB0","description":"ICD-IELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA0","description":"ICD-BCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0982T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","description":"CPT-0982T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC25","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA1","description":"ICD-OKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prkns diag rviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1400F","description":"Prkns diag rviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44210","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID1","description":"ICD-OIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB0","description":"ICD-KHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extra ambulance attendant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0424","description":"Extra ambulance attendant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA0","description":"ICD-FDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC0","description":"ICD-KDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF1","description":"ICD-MKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC1","description":"ICD-ODVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32851","description":"Lung transplant single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home visit cath maintain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99507","description":"Home visit cath maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA0","description":"ICD-IBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD1","description":"ICD-OIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28615","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC1","description":"ICD-FFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43113","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tacrine hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0014","description":"Tacrine hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Couns potent glauc impct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4174F","description":"Couns potent glauc impct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Halo cervical into jckt vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0810","description":"Halo cervical into jckt vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8608","description":"Miscellaneous external component_ supply or accessory for use with the Argus II Retinal Prosthesis System","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20102","description":"Explore wound abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 1 sting insect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95130","description":"Immntx 1 sting insect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF0","description":"ICD-BECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9151","description":"Injection_ pegcetacoplan_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF1","description":"ICD-OECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD1","description":"ICD-NCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC0","description":"ICD-JBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stab phleb veins xtr 10-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37765","description":"Stab phleb veins xtr 10-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24357","description":"Repair elbow perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF0","description":"ICD-NCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF0","description":"ICD-BHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD0","description":"ICD-PASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/1-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34804","description":"Endovas aaa repr w/1-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF1","description":"ICD-ODUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED0","description":"ICD-JEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC0","description":"ICD-MLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED1","description":"ICD-KBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB0","description":"ICD-NCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93621","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for home delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8415","description":"Supplies for home delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC1","description":"ICD-FCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC50","description":"High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA1","description":"ICD-NFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE0","description":"ICD-NKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA0","description":"ICD-KDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB0","description":"ICD-BBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"TB screening not performed or results not interpreted_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1005","description":"TB screening not performed or results not interpreted_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA0","description":"ICD-NFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interdental fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21110","description":"Interdental fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA0","description":"ICD-CGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE1","description":"ICD-GFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD1","description":"ICD-OBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3268","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3268","description":"HCPCS-J3268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92532","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF1","description":"ICD-GGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB1","description":"ICD-OLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oxy suppl heater for nebuliz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1372","description":"Oxy suppl heater for nebuliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Carry goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8985","description":"Carry goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vendaje ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4279","description":"Vendaje ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD0","description":"ICD-JFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97814","description":"Acupunct w/stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC15","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA0","description":"ICD-OJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy remov fb/fibrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32653","description":"Thoracoscopy remov fb/fibrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Air pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0186","description":"Air pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE0","description":"ICD-PKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD0","description":"ICD-GBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3310","description":"Anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No filt remov w/in 3mos plcm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9544","description":"No filt remov w/in 3mos plcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pedicle soft tissue graft pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4270","description":"Pedicle soft tissue graft pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB1","description":"ICD-MCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB1","description":"ICD-MCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24560","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC31","description":"ICD-2AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","description":"HCPCS-E1813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB1","description":"ICD-JDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Euflexxa inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7323","description":"Euflexxa inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mrgfus strtctc les abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398T","description":"Mrgfus strtctc les abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD0","description":"ICD-FCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC230","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecg record/review","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93268","description":"Ecg record/review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC0","description":"ICD-AEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no events on discharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8907","description":"Pt doc no events on discharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA1","description":"ICD-MEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eptinezumab-jjmr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3032","description":"Injection_ eptinezumab-jjmr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE0","description":"ICD-GBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1017T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","description":"CPT-1017T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF1","description":"ICD-OEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE1","description":"ICD-MLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supply kit premix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4220","description":"Parenteral supply kit premix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of spinal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27105","description":"Transfer of spinal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81328","description":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occupational multifocal lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2786","description":"Occupational multifocal lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0663","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","description":"HCPCS-G0663","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acute gi blood loss imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78278","description":"Acute gi blood loss imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA1","description":"ICD-OFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA1","description":"ICD-OFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE1","description":"ICD-FFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE0","description":"ICD-CDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-82233","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","description":"CPT-82233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95983","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1023","description":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB55","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0785T","description":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0703T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote retinal imaging mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92228","description":"Remote retinal imaging mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2003","description":"HCPCS-B2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42210","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD1","description":"ICD-KGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Temozolomide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9328","description":"Temozolomide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home std case rate 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0270","description":"Home std case rate 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99379","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE0","description":"ICD-CBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC1","description":"ICD-GFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o pseudobulbaffect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3757F","description":"Pt w/o pseudobulbaffect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31530","description":"Laryngoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE0","description":"ICD-GHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB1","description":"ICD-KDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA1","description":"ICD-GESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND1","description":"ICD-BDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE1","description":"ICD-BGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD0","description":"ICD-FGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic band & belt thigh fla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2192","description":"Pelvic band & belt thigh fla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA11","description":"ICD-2GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA1","description":"ICD-NBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD214","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA0","description":"ICD-MIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:2 to 1:3)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1729","description":"Employment - Employment Skills Development (1:2 to 1:3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA0","description":"ICD-KIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped size brief/diaper sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4529","description":"Ped size brief/diaper sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA1","description":"ICD-NJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Attendant care service /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5126","description":"Attendant care service /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA0","description":"ICD-OKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Filters elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0500","description":"Filters elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 4.12-7.0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2201","description":"Lens sphere bifocal 4.12-7.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spectrophotometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84311","description":"Spectrophotometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC1","description":"ICD-KDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC0","description":"ICD-FFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44125","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF0","description":"ICD-MBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd inj >24h/gcs >15/no res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9596","description":"Hd inj >24h/gcs >15/no res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0204","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB0","description":"ICD-FCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27006","description":"Incision of hip tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC21","description":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0535","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","description":"HCPCS-G0535","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt lft inpt fac w/in 60 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1110F","description":"Pt lft inpt fac w/in 60 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tear duct system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68899","description":"Tear duct system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD0","description":"ICD-FHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE0","description":"ICD-KAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71023","description":"Chest x-ray and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Topical app of fluoride","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1208","description":"Topical app of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & ureter catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52005","description":"Cystoscopy & ureter catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61600","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art or venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4750","description":"Art or venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9707","description":"Patient received hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD0","description":"ICD-PIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB0","description":"ICD-NGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF0","description":"ICD-KGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6210","description":"Foam drg >16<=48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd no inhal anesthic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4555F","description":"Pt recvd no inhal anesthic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87341","description":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy addl cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63043","description":"Laminotomy addl cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD0","description":"ICD-GGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt lithium 3.6 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0604","description":"Repl batt lithium 3.6 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA0","description":"ICD-AFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Offset knee joint heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2395","description":"Offset knee joint heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA0","description":"ICD-BIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD0","description":"ICD-EBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC1","description":"ICD-FIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & decompress","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45337","description":"Sigmoidoscopy & decompress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap colectomy part w/ileum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44205","description":"Lap colectomy part w/ileum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93000","description":"Electrocardiogram complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB0","description":"ICD-NEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC1","description":"ICD-GDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc visit unspecified nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9055","description":"Onc visit unspecified nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach pros cleaning device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8513","description":"Trach pros cleaning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC0","description":"ICD-KBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23532","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Microdissection manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88381","description":"Microdissection manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD0","description":"ICD-CHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA0","description":"ICD-JGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED0","description":"ICD-FDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80305","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29520","description":"Strapping of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB0","description":"ICD-CDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46999","description":"Anus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill/fem/fem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35533","description":"Art byp grft axill/fem/fem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA1","description":"ICD-IEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37235","description":"Tib/per revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB0","description":"ICD-EGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24116","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE1","description":"ICD-NDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA0","description":"ICD-DCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF0","description":"ICD-MGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF1","description":"ICD-CHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE130","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2056","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0883T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB1","description":"ICD-DCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA1","description":"ICD-CGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD0","description":"ICD-MHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE1","description":"ICD-ECDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA0","description":"ICD-FFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB1","description":"ICD-LIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB0","description":"ICD-FEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC0","description":"ICD-MIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp >/= 90 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3080F","description":"Diast bp >/= 90 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"VitoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4317","description":"VitoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED0","description":"ICD-OAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Free fascial flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15758","description":"Free fascial flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gr 34 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2358","description":"Gr 34 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE116","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity classified mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1491F","description":"Dem severity classified mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124A","description":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF0","description":"ICD-FAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coma stimulation per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9056","description":"Coma stimulation per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE0","description":"ICD-KAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB1","description":"ICD-AHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB1","description":"ICD-CCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB1","description":"ICD-CDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4270F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC1","description":"ICD-PHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC0","description":"ICD-NHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE0","description":"ICD-ECUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD0","description":"ICD-NBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85301","description":"Antithrombin iii antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF1","description":"ICD-HEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD0","description":"ICD-DBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8635","description":"No pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had one or less emergency department visits in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9851","description":"Patient had one or less emergency department visits in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93793","description":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD0","description":"ICD-NAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA0","description":"ICD-NHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD1","description":"ICD-LGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft carotid-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35510","description":"Art byp grft carotid-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC0","description":"ICD-NECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB1","description":"ICD-OKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0137","description":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB0","description":"ICD-PEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23460","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME0","description":"ICD-OBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB0","description":"ICD-NAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55720","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB0","description":"ICD-JBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Kcentra_ per i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9132","description":"Kcentra_ per i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient received chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9847","description":"Patient received chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF1","description":"ICD-BHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4773","description":"Occult blood test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB0","description":"ICD-FBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF1","description":"ICD-KIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26410","description":"Repair hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inc for vagus n elect impl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64568","description":"Inc for vagus n elect impl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lpn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1031","description":"Lpn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin k phytonadione inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3430","description":"Vitamin k phytonadione inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD1","description":"ICD-KEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA41","description":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Round caliper and plate atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2240","description":"Round caliper and plate atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9104","description":"Onc dx gastric unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Corneal tissue transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65767","description":"Corneal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE1","description":"ICD-LIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF0","description":"ICD-JGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63302","description":"Remove vert xdrl body thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mental/Behavioral Health Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4013","description":"Mental/Behavioral Health Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ONC SLD TUM ALYS BRCA1 BRCA2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172U","description":"ONC SLD TUM ALYS BRCA1 BRCA2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24576","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF1","description":"ICD-IHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC1","description":"ICD-MEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved oral anticoagulant is prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8967","description":"Warfarin or another FDA-approved oral anticoagulant is prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF0","description":"ICD-CBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC1","description":"ICD-KHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF1","description":"ICD-MACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD1","description":"ICD-JATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Md document visit by npp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0454","description":"Md document visit by npp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq tcat intratrl septl sht","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0613T","description":"Perq tcat intratrl septl sht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA0","description":"ICD-FHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Grafix Prime and GrafixPL Prime_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4133","description":"Grafix Prime and GrafixPL Prime_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9352","description":"Injection_ trabectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE0","description":"ICD-BDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4010","description":"Infectious Disease Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD1","description":"ICD-FFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA0","description":"ICD-GBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB101","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB1","description":"ICD-IDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27700","description":"Revision of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4295","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","description":"HCPCS-A4295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cessj therapy cath removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37214","description":"Cessj therapy cath removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE1","description":"ICD-GCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67550","description":"Insert eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE1","description":"ICD-OGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX12","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95724","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA0","description":"ICD-GDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37250","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier powder per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4371","description":"Skin barrier powder per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI jnt of lwr extre w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73721","description":"MRI jnt of lwr extre w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8X","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC1","description":"ICD-OIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE1","description":"ICD-FDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE1","description":"ICD-PCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA1","description":"ICD-NDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE1","description":"ICD-AIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Staggered spondaic word test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92572","description":"Staggered spondaic word test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adapt/ext_ pacing/neuro lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1883","description":"Adapt/ext_ pacing/neuro lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB0","description":"ICD-KGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5251","description":"Hearing aid_ prog_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dschrg med/current med merge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1111F","description":"Dschrg med/current med merge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF1","description":"ICD-JACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0068","description":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0174","description":"Dolasetron 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD0","description":"ICD-DBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9175","description":"Speech lang goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD1","description":"ICD-NKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF0","description":"ICD-MBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA53","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0822","description":"Pwc gp 2 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6064","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC0","description":"ICD-CDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"2 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4207","description":"2 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC53","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0519","description":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30118","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9122","description":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC1","description":"ICD-GEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA0","description":"ICD-NABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA0","description":"ICD-NCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA1","description":"ICD-HCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF1","description":"ICD-NBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Protein e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84165","description":"Protein e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE0","description":"ICD-IELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ Cardiac Contractility Modulation (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1824","description":"Generator_ Cardiac Contractility Modulation (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163U","description":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD0","description":"ICD-KIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB0","description":"ICD-CGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB11","description":"ICD-2FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA1","description":"ICD-HGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61537","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dyphylline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1180","description":"Dyphylline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26060","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB0","description":"ICD-EALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultrafiltration monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9007","description":"Ultrafiltration monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0077U","description":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE0","description":"ICD-KDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC0","description":"ICD-AGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA1","description":"ICD-EEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1606","description":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Situximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9455","description":"Injection_ Situximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE0","description":"ICD-FGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hit picc insert no supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5522","description":"Hit picc insert no supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93896","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","description":"CPT-93896","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB0","description":"ICD-OJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE1","description":"ICD-FHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA1","description":"ICD-HBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61612","description":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB52","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB0","description":"ICD-FIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74241","description":"X-ray upper gi delay w/kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 4+ prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34848","description":"Visc & infraren abd 4+ prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD1","description":"ICD-MDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC0","description":"ICD-OAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD0","description":"ICD-MIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF0","description":"ICD-OFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95938","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37296","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","description":"CPT-37296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients Under Hospice Care In The Current Reporting Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0051","description":"Patients Under Hospice Care In The Current Reporting Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6011","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2099","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61610","description":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC1","description":"ICD-KCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF0","description":"ICD-BBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE0","description":"ICD-FAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE0","description":"ICD-BIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB0","description":"ICD-FIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0188","description":"Synthetic sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF0","description":"ICD-KHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD0","description":"ICD-CIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68811","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sensory integration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97533","description":"Sensory integration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC21","description":"ICD-2CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neck/chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21899","description":"Neck/chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE0","description":"ICD-PISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onlay porc/crmc >=3 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6609","description":"Onlay porc/crmc >=3 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB0","description":"ICD-BAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric service/therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90899","description":"Psychiatric service/therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA1","description":"ICD-NLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE0","description":"ICD-KHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC36","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove sciatic nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64786","description":"Remove sciatic nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB1","description":"ICD-BFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA0","description":"ICD-DGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC1","description":"ICD-KCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81349","description":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Urology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4037","description":"Urology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC1","description":"ICD-KBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF0","description":"ICD-CENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB31","description":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES306","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Csf ventriculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78635","description":"Csf ventriculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD0","description":"ICD-JGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE0","description":"ICD-BGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test non-trep quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86593","description":"Syphilis test non-trep quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0507U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","description":"CPT-0507U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0761T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA0","description":"ICD-CEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92534","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no ann srn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9384","description":"Doc med reas no ann srn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85018","description":"Hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD0","description":"ICD-KCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA0","description":"ICD-NKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF0","description":"ICD-HHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE1","description":"ICD-FHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald blu tooth fm/dm receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5286","description":"Ald blu tooth fm/dm receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC236","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD1","description":"ICD-JDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB1","description":"ICD-OAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC1","description":"ICD-OLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD0","description":"ICD-KCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant/replace hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69710","description":"Implant/replace hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF1","description":"ICD-KHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE1","description":"ICD-OJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepc mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8549","description":"Hepc mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF0","description":"ICD-OECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF0","description":"ICD-NLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE1","description":"ICD-FHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA1","description":"ICD-KHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prq card angio/athrect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92925","description":"Prq card angio/athrect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases w/o2 saturation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82805","description":"Blood gases w/o2 saturation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83690","description":"Assay of lipase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298U","description":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 3rd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36247","description":"Ins cath abd/l-ext art 3rd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cylinder tank carrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2208","description":"Cylinder tank carrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD1","description":"ICD-IBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC0","description":"ICD-GFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA31","description":"ICD-3EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert w/o lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5679","description":"Socket insert w/o lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA0","description":"ICD-NAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62269","description":"Needle biopsy spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF0","description":"ICD-CIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tubular dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6457","description":"Tubular dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF0","description":"ICD-PJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME0","description":"ICD-OHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF0","description":"ICD-JAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB1","description":"ICD-IHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB0","description":"ICD-CAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB0","description":"ICD-IGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA0","description":"ICD-IHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC0","description":"ICD-GFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA1","description":"ICD-NDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE1","description":"ICD-GHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87638","description":"CPT-87638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF0","description":"ICD-ODNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2225","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath report nongyn spcmn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550F","description":"Cytopath report nongyn spcmn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29898","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pericard exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32661","description":"Thoracoscopy w/pericard exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA0","description":"ICD-ACIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26992","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD0","description":"ICD-DHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-ophthalmic fva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9733","description":"Non-ophthalmic fva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF1","description":"ICD-OHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD0","description":"ICD-CDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB1","description":"ICD-KFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA1","description":"ICD-CDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL50","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF0","description":"ICD-EEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9305","description":"No interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC1","description":"ICD-MDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo physician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9153","description":"Mapcp demo physician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB0","description":"ICD-EFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA0","description":"ICD-FETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC1","description":"ICD-NGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47490","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA0","description":"ICD-FAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD0","description":"ICD-KFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0877","description":"Injection_ daptomycin (hospira)_ not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC0","description":"ICD-HESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA1","description":"ICD-IATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1B","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML02","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90679","description":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE0","description":"ICD-ABHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 xhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0840","description":"Pwc gp2 xhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA1","description":"ICD-OIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC0","description":"ICD-CEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31637","description":"Bronchoscopy stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE1","description":"ICD-PGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck organ 1yr/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32051","description":"Anesth neck organ 1yr/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND0","description":"ICD-BCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC0","description":"ICD-NLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD1","description":"ICD-NKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE0","description":"ICD-OKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB0","description":"ICD-NKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA1","description":"ICD-GEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB0","description":"ICD-DIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1037","description":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA1","description":"ICD-NFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA0","description":"ICD-NICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Consult slides prep elsewher","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0484","description":"Consult slides prep elsewher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect distal finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26262","description":"Resect distal finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF1","description":"ICD-EIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA0","description":"ICD-HDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83036","description":"Glycosylated hemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB1","description":"ICD-KEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts pt no e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8673","description":"Fun stat scor nek/ts pt no e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78265","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB1","description":"ICD-KBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC1","description":"ICD-MGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE0","description":"ICD-OCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication athletic guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9941","description":"Fabrication athletic guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin 250-500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96921","description":"Laser tx skin 250-500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE1","description":"ICD-JCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Set-Up Fees)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7335","description":"Community Transition Svcs (Set-Up Fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84234","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurosurgical Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4016","description":"Neurosurgical Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplan desig abdu pos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3960","description":"Sewho airplan desig abdu pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Artery-vein nonautograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36830","description":"Artery-vein nonautograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE1","description":"ICD-FDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB0","description":"ICD-AHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF0","description":"ICD-KCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC1","description":"ICD-CIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB11","description":"ICD-3EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9819","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27519","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE0","description":"ICD-OKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES160","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF0","description":"ICD-GFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA0","description":"ICD-JIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD0","description":"ICD-PHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA0","description":"ICD-OKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57250","description":"Repair rectum & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01850","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","description":"CPT-01850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA21","description":"ICD-1DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image (ef)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78468","description":"Heart infarct image (ef)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF0","description":"ICD-KDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose & septal fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21335","description":"Open tx nose & septal fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE1","description":"ICD-CHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA1","description":"ICD-MDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ovrsght xtrcorp liv asst pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405T","description":"Ovrsght xtrcorp liv asst pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE1","description":"ICD-DGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vehicle Modifications","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0139","description":"Vehicle Modifications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC1","description":"ICD-GDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC1","description":"ICD-BFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD1","description":"ICD-JFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44402","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED1","description":"ICD-GGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF1","description":"ICD-CFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87517","description":"Hepatitis b dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA0","description":"ICD-GBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD1","description":"ICD-NKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc endocrine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60659","description":"Laparo proc endocrine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE0","description":"ICD-MIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radio/surgical implant index","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6190","description":"Radio/surgical implant index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD0","description":"ICD-PLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB0","description":"ICD-AAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC1","description":"ICD-BCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0037U","description":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6221","description":"Gauze > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF1","description":"ICD-GEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB0","description":"ICD-EEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC0","description":"ICD-IHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE1","description":"ICD-GIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME0","description":"ICD-AAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB1","description":"ICD-OBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED1","description":"ICD-FGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB260","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF0","description":"ICD-BFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1083","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA1","description":"ICD-MCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pelv fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22848","description":"Insert pelv fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF0","description":"ICD-FCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD1","description":"ICD-OAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71551","description":"MRI chest w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC0","description":"ICD-NDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB217","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF1","description":"ICD-NDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB0","description":"ICD-JALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tear film img uni/bi w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330T","description":"Tear film img uni/bi w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93619","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Femoral lgth sock fx or equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2850","description":"Femoral lgth sock fx or equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA0","description":"ICD-CFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC0","description":"ICD-EIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC21","description":"ICD-4EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"N block inj common digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64632","description":"N block inj common digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE1","description":"ICD-CCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0684T","description":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53502","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oritavancin (Kimyrsa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2406","description":"Injection_ oritavancin (Kimyrsa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB1","description":"ICD-OFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE1","description":"ICD-OHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0426","description":"Inpt/ed teleconsult50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC0","description":"ICD-CDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF0","description":"ICD-EEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald neck_ loop ind receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5283","description":"Ald neck_ loop ind receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96158","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE0","description":"ICD-KHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE0","description":"ICD-KDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB1","description":"ICD-ODJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE0","description":"ICD-BEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Female patients unable to bear children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1016","description":"Female patients unable to bear children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA0","description":"ICD-DAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB11","description":"ICD-3BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF0","description":"ICD-KIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA1","description":"ICD-FEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31605","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF1","description":"ICD-EBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB1","description":"ICD-KIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dronabinol 2.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0167","description":"Dronabinol 2.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0B","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX51","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF0","description":"ICD-KINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB1","description":"ICD-FGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8F","description":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF1","description":"ICD-OLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE1","description":"ICD-GDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ca screen;pelvic/breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0101","description":"Ca screen;pelvic/breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","description":"CPT-76014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA1","description":"ICD-DASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92275","description":"Electroretinography with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Belt_ strap_ sleeve_ garment_ or covering_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4467","description":"Belt_ strap_ sleeve_ garment_ or covering_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27696","description":"Repair of ankle ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2102","description":"Adjunctive continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hhc rn e&m plan svs_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0162","description":"Hhc rn e&m plan svs_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB0","description":"ICD-OJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea scrnd mod-high dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3451F","description":"Dyspnea scrnd mod-high dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD0","description":"ICD-FFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35182","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA1","description":"ICD-MIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9150","description":"Xenon xe-129 hyperpolarized gas_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6237","description":"Hydrocolld drg <=16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF1","description":"ICD-DHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB1","description":"ICD-GGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC1","description":"ICD-GECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF0","description":"ICD-FAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE1","description":"ICD-CBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB1","description":"ICD-KGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED1","description":"ICD-EGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD1","description":"ICD-FICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD0","description":"ICD-NGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thromboemb risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1180F","description":"Thromboemb risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier 6x6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5121","description":"Solid skin barrier 6x6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93016","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove palate/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42120","description":"Remove palate/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA46","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Double transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26554","description":"Double transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp lt 130 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3074F","description":"Syst bp lt 130 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB1","description":"ICD-CCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA230","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA0","description":"ICD-EEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE1","description":"ICD-OEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digit nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64778","description":"Digit nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC0","description":"ICD-FFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD1","description":"ICD-JEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB1","description":"ICD-EHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKS","description":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drsg gel filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6248","description":"Hydrogel drsg gel filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA1","description":"ICD-JIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC1","description":"ICD-GBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99403","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF0","description":"ICD-NCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF0","description":"ICD-BDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE1","description":"ICD-PDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esw wound healing addl wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300T","description":"Esw wound healing addl wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE1","description":"ICD-PCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD0","description":"ICD-FIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC1","description":"ICD-OCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB0","description":"ICD-OKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heat lamp with stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0205","description":"Heat lamp with stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID1","description":"ICD-ECID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB25","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21076","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up surgery of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66250","description":"Follow-up surgery of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA0","description":"ICD-BBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA1","description":"ICD-KHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0402","description":"Injection_ aripiprazole (abilify asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50630","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1081","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF1","description":"ICD-CEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody elution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86860","description":"Rbc antibody elution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD0","description":"ICD-JBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC0","description":"ICD-JHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD0","description":"ICD-FBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE0","description":"ICD-OFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD1","description":"ICD-DFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biomechanical mapping_ transvaginal_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0487T","description":"Biomechanical mapping_ transvaginal_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed xtra hvy dty x wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0304","description":"Hosp bed xtra hvy dty x wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2015","description":"Comp comm supp svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC0","description":"ICD-GDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB214","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4045","description":"Cast sup sht leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE1","description":"ICD-KGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Deb bone 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11044","description":"Deb bone 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0825T","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1132","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28264","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Autosomal Dominant Thromboc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269U","description":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Autosomal Dominant Thromboc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD1","description":"ICD-GBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ureter lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51535","description":"Repair of ureter lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB1","description":"ICD-KHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD1","description":"ICD-JDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE0","description":"ICD-MCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE1","description":"ICD-GFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC1","description":"ICD-FCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81383","description":"Hla ii typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF0","description":"ICD-NIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED0","description":"ICD-JHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE1","description":"ICD-PAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol mask used w nebulize","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7015","description":"Aerosol mask used w nebulize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone algrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20931","description":"Sp bone algrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92512","description":"Nasal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA0","description":"ICD-KICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC31","description":"ICD-1EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB16","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC1","description":"ICD-CCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC0","description":"ICD-EBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE1","description":"ICD-JFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3370F","description":"Ajcc brst cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst t/o & repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58292","description":"Vag hyst t/o & repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF0","description":"ICD-GHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB0","description":"ICD-FEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF1","description":"ICD-OGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd trapeze bar attach to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0911","description":"Hd trapeze bar attach to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo sling operation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51992","description":"Laparo sling operation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE0","description":"ICD-OGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electric stimulation therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97014","description":"Electric stimulation therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD1","description":"ICD-OEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD1","description":"ICD-PEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB0","description":"ICD-KHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD1","description":"ICD-HFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0804","description":"CDT-D0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap mobil splenic fl add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44213","description":"Lap mobil splenic fl add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Admin ecg contrast agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93352","description":"Admin ecg contrast agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0947T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","description":"CPT-0947T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0279U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA1","description":"ICD-ICDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF1","description":"ICD-EEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC0","description":"ICD-OJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA0","description":"ICD-JCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB1","description":"ICD-PKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC0","description":"ICD-NGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC1","description":"ICD-KFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ra meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8499","description":"Ra meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35538","description":"Art byp grft aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB1","description":"ICD-OJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted procedure colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45399","description":"Unlisted procedure colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Phq-scr >9 doc in 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9572","description":"Phq-scr >9 doc in 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD1","description":"ICD-DASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA0","description":"ICD-FGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED1","description":"ICD-ACED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clin depres scrn no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8511","description":"Clin depres scrn no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB1","description":"ICD-NJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder lock actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6647","description":"Shoulder lock actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF0","description":"ICD-IGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND0","description":"ICD-CGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD1","description":"ICD-KAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB0","description":"ICD-BDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB0","description":"ICD-BBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9220","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","description":"HCPCS-J9220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC1","description":"ICD-OGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC0","description":"ICD-GIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD1","description":"ICD-KAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert pessary/other device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57160","description":"Insert pessary/other device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB1","description":"ICD-FCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB0","description":"ICD-OEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26593","description":"Release muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87472","description":"Bartonella dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0477U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","description":"CPT-0477U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE1","description":"ICD-MFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA0","description":"ICD-JCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0704","description":"HCPCS-B0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17270","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD0","description":"ICD-CFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3208","description":"Surgical boot each infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB0","description":"ICD-BGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF1","description":"ICD-HIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC0","description":"ICD-IHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB226","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75891","description":"Vein x-ray liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78431","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD0","description":"ICD-MDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE1","description":"ICD-KCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD1","description":"ICD-ODAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE0","description":"ICD-IGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97167","description":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA1","description":"ICD-GBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF0","description":"ICD-GIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destroy c/th facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64634","description":"Destroy c/th facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB1","description":"ICD-NHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA1","description":"ICD-HGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC1","description":"ICD-KEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC03","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 9-10 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95911","description":"Nrv cndj test 9-10 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF1","description":"ICD-NFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME0","description":"ICD-AEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC0","description":"ICD-OIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB0","description":"ICD-PBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC10","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA0","description":"ICD-OKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB1","description":"ICD-MDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69719","description":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amniotext patch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4247","description":"Amniotext patch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA1","description":"ICD-ECDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0B","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA1","description":"ICD-KIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelv w/contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74177","description":"Ct abd & pelv w/contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA1","description":"ICD-GAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB1","description":"ICD-BHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recd cortico >=10mg/day >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9467","description":"Recd cortico >=10mg/day >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF0","description":"ICD-OGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE0","description":"ICD-NAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32506","description":"Wedge resect of lung add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC0","description":"ICD-LGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15736","description":"Muscle-skin graft arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57311","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD1","description":"ICD-FGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE0","description":"ICD-CHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA0","description":"ICD-DESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD0","description":"ICD-EGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Self-care ed provided to pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4450F","description":"Self-care ed provided to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antb addl slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88341","description":"Immunohisto antb addl slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB1","description":"ICD-FABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rapid desensitization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95180","description":"Rapid desensitization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE1","description":"ICD-FIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58553","description":"Laparo-vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE0","description":"ICD-NETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal pelvic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38562","description":"Removal pelvic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF1","description":"ICD-KIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infus insulin pump non needl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4230","description":"Infus insulin pump non needl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lympho venereum antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86729","description":"Lympho venereum antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Splint - intra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4322","description":"Splint - intra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0018","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0763T","description":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC1","description":"ICD-KGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC0","description":"ICD-KFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28540","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infusion supplies with pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4222","description":"Infusion supplies with pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0506","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1202","description":"HCPCS-B1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME1","description":"ICD-AFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA0","description":"ICD-CARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB0","description":"ICD-BGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pca3/klk3 antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81313","description":"Pca3/klk3 antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0158U","description":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6520","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0821","description":"Pwc gp 2 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92997","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0652","description":"Injection_ levothyroxine sodium (hikma) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63056","description":"Decompress spinal cord lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB1","description":"ICD-JHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF1","description":"ICD-NBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF0","description":"ICD-BEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj follitropin beta 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0128","description":"Inj follitropin beta 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9959","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9959","description":"CDT-D9959","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No electrodiag polyneuro 6mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3752F","description":"No electrodiag polyneuro 6mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC1","description":"ICD-CGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA0","description":"ICD-NHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF0","description":"ICD-FFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace pump_ alt press pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0182","description":"Replace pump_ alt press pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF0","description":"ICD-BAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90584","description":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7524","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB0","description":"ICD-AIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE0","description":"ICD-FBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD0","description":"ICD-OJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Heart revascularize (tmr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33140","description":"Heart revascularize (tmr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED0","description":"ICD-JAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45388","description":"Colonoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB0","description":"ICD-BBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD1","description":"ICD-JCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB1","description":"ICD-KGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"4-bar link above knee w/swng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5614","description":"4-bar link above knee w/swng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA13","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC0","description":"ICD-NGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE1","description":"ICD-PHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6039","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME0","description":"ICD-CBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9769","description":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC0","description":"ICD-NBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF0","description":"ICD-MDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87497","description":"Cytomeg dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD1","description":"ICD-KDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF1","description":"ICD-OKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD160","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Delivery/set up/dispensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9901","description":"Delivery/set up/dispensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Neurological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95999","description":"Neurological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC1","description":"ICD-EELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of breath ethanol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82075","description":"Assay of breath ethanol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB1","description":"ICD-DDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE0","description":"ICD-BEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25628","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC1","description":"ICD-FBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE1","description":"ICD-OLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lamellas xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4291","description":"Lamellas xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB32","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE0","description":"ICD-FFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE1","description":"ICD-FEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1113","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE0","description":"ICD-OEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87551","description":"Mycobacteria dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA15","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29846","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE1","description":"ICD-LERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repl girdle milwaukee orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4000","description":"Repl girdle milwaukee orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC1","description":"ICD-LHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay dipropylacetic acd tot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80164","description":"Assay dipropylacetic acd tot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extension per extension per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2760","description":"Extension per extension per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD1","description":"ICD-OGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF1","description":"ICD-IEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB1","description":"ICD-DIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj ivig privigen 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1459","description":"Inj ivig privigen 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF1","description":"ICD-LIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF0","description":"ICD-KDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE1","description":"ICD-KCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA1","description":"ICD-GCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC0","description":"ICD-NCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28312","description":"Revision of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE0","description":"ICD-NAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA0","description":"ICD-BINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0696T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD124","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE0","description":"ICD-EEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC1","description":"ICD-OAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC1","description":"ICD-HCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF0","description":"ICD-NFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21084","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE1","description":"ICD-CBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD1","description":"ICD-FHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF1","description":"ICD-PFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45051","description":"Anesth surgery of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0615U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","description":"CPT-0615U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC0","description":"ICD-OKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB0","description":"ICD-JELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF1","description":"ICD-CGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE1","description":"ICD-OANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation tx management x5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77427","description":"Radiation tx management x5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stimulation of spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63610","description":"Stimulation of spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","description":"HCPCS-J2802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE0","description":"ICD-JEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA0","description":"ICD-NKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have an order for or are receiving hospice or palliative care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1186","description":"Patients who have an order for or are receiving hospice or palliative care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD1","description":"ICD-OBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF0","description":"ICD-OKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA0","description":"ICD-MCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23040","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC1","description":"ICD-ACMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF1","description":"ICD-PHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bld glucose monitor w lance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2101","description":"Bld glucose monitor w lance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC0","description":"ICD-GHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE1","description":"ICD-PIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC1","description":"ICD-OHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9046","description":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51845","description":"Repair bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC0","description":"ICD-KDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA21","description":"ICD-3LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA1","description":"ICD-JGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","description":"HCPCS-L6032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB1","description":"ICD-BGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE1","description":"ICD-OIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glasses bicros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5230","description":"Glasses bicros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9910","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac drug stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93024","description":"Cardiac drug stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA1","description":"ICD-CHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB0","description":"ICD-HGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replace g/c tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49450","description":"Replace g/c tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA0","description":"ICD-EABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB0","description":"ICD-OBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB0","description":"ICD-GBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7657","description":"Isoproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX46","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB0","description":"ICD-HASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coronary_ temporary_ with delivery system (propel)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1091","description":"Stent_ non-coronary_ temporary_ with delivery system (propel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve remov init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31648","description":"Bronchial valve remov init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC1","description":"ICD-FILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA1","description":"ICD-KAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359T","description":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mucopolysaccharides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83864","description":"Mucopolysaccharides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","description":"HCPCS-Q4427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD1","description":"ICD-BIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0603","description":"CDT-D0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA0","description":"ICD-OIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insert self-contd prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54401","description":"Insert self-contd prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/fhd w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21160","description":"Lefort iii w/fhd w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy test-delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95028","description":"Icut allergy test-delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9203","description":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD1","description":"ICD-JAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer administration set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7003","description":"Nebulizer administration set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC1","description":"ICD-GDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pt trans to hosp post d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8914","description":"Pt trans to hosp post d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0620U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","description":"CPT-0620U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9327","description":"Ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE1","description":"ICD-GEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9905","description":"Patient not screened for tobacco use_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rx corneoscleral cntact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92317","description":"Rx corneoscleral cntact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF0","description":"ICD-FCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74249","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA1","description":"ICD-GHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73202","description":"Ct uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anogenital exam child w imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99170","description":"Anogenital exam child w imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE1","description":"ICD-ADUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC0","description":"ICD-BCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA1","description":"ICD-JIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC1","description":"ICD-ECIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"W/c dpth 20-21 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2342","description":"W/c dpth 20-21 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB1","description":"ICD-FBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC1","description":"ICD-NHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Umbilical artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76820","description":"Umbilical artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tendon transfer with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26492","description":"Tendon transfer with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD155","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB0","description":"ICD-LCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF1","description":"ICD-CAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Release knuckle contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26520","description":"Release knuckle contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA0","description":"ICD-FCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Each addtnl prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2957","description":"Each addtnl prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81165","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD117","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC1","description":"ICD-CEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene dup/delet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81324","description":"Pmp22 gene dup/delet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coronary art/grft angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93455","description":"Coronary art/grft angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE1","description":"ICD-JDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA1","description":"ICD-MIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB117","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lap impl electrode antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43647","description":"Lap impl electrode antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0701","description":"CDT-D0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA0","description":"ICD-OHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Airways surgical procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31899","description":"Airways surgical procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA1","description":"ICD-BBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88025","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD0","description":"ICD-GAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB0","description":"ICD-KAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE117","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB0","description":"ICD-CDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC1","description":"ICD-KBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE0","description":"ICD-MJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF0","description":"ICD-DFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surg lower abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84051","description":"Anesth surg lower abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise kneecap with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27438","description":"Revise kneecap with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF0","description":"ICD-FHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE0","description":"ICD-CHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE136","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise lip or cheek fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40819","description":"Excise lip or cheek fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9998","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","description":"HCPCS-Q9998","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3105","description":"Terbutaline sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA0","description":"ICD-CCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB0","description":"ICD-NIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE0","description":"ICD-GAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33957","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE0","description":"ICD-CERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oversize lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2780","description":"Oversize lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC1","description":"ICD-OKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28755","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE1","description":"ICD-KIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB1","description":"ICD-GIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calibrator solution/chips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4256","description":"Calibrator solution/chips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42894","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA0","description":"ICD-BBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44620","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin < 250 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96920","description":"Laser tx skin < 250 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of androsterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82160","description":"Assay of androsterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC0","description":"ICD-GGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0880","description":"Pwc gp4 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB1","description":"ICD-KGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit new patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0466","description":"Fqhc visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB0","description":"ICD-FGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69222","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA1","description":"ICD-CFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Multi den insert custom mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5513","description":"Multi den insert custom mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Test sock elbw disart/above","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6682","description":"Test sock elbw disart/above","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC34","description":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1034","description":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC0","description":"ICD-JFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24920","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD125","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Report_ prev care measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8486","description":"Report_ prev care measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE1","description":"ICD-JGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE1","description":"ICD-KELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD1","description":"ICD-JICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon extent unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9089","description":"Onc dx colon extent unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49593","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE1","description":"ICD-KAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF1","description":"ICD-OGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Balloon dilate urtrl strix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50706","description":"Balloon dilate urtrl strix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81507","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC0","description":"ICD-JHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2002","description":"CDT-D2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0893","description":"Injection_ decitabine (sun pharma) not therapeutically equivalent to j0894_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Safety counseling dem order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6102F","description":"Safety counseling dem order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC0","description":"ICD-CBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inject r ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93566","description":"Inject r ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6447","description":"Conform band s w >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC1","description":"ICD-KEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF0","description":"ICD-OIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB1","description":"ICD-AAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC0","description":"ICD-GFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES326","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB1","description":"ICD-CBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC0","description":"ICD-KIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC0","description":"ICD-OJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ziconotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2278","description":"Ziconotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB1","description":"ICD-KAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA1","description":"ICD-ECEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34717","description":"Endovascular Repair Of Iliac Artery At The Time Of Aorto-Iliac Artery Endograft Placement By Deployment Of An Iliac Branched Endograft Including Pre-Procedure Sizing And Devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0637","description":"Lso sc r ant/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Foot press off load supp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9283","description":"Foot press off load supp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87627","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","description":"CPT-87627","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA31","description":"ICD-1BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA0","description":"ICD-FHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA234","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB1","description":"ICD-CIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF1","description":"ICD-EHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF0","description":"ICD-BBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27248","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA1","description":"ICD-MKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL17","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gastro-Enterology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4006","description":"Gastro-Enterology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF0","description":"ICD-KIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA1","description":"ICD-KFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD1","description":"ICD-BHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mandible graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7950","description":"Mandible graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Maxillofacial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5999","description":"Maxillofacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36573","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA30","description":"Default_ /30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD0","description":"ICD-GDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB1","description":"ICD-CBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93976","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunfix e-phorsis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86335","description":"Immunfix e-phorsis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF1","description":"ICD-BFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB1","description":"ICD-JHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD1","description":"ICD-PHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC0","description":"ICD-IAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC1","description":"ICD-KFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ear mold/insert_ disp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5265","description":"Ear mold/insert_ disp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec downld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94776","description":"Ped home apnea rec downld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA0","description":"ICD-BGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB0","description":"ICD-KGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA0","description":"ICD-JFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC1","description":"ICD-GEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB0","description":"ICD-LIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69730","description":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB205","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA0","description":"ICD-ECTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3933","description":"Fo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB1","description":"ICD-BHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA1","description":"ICD-OFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB0","description":"ICD-NALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube non-cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7520","description":"Trach/laryn tube non-cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL45","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC0","description":"ICD-NKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB1","description":"ICD-GCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB1","description":"ICD-BGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD1","description":"ICD-EDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42720","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD0","description":"ICD-ODLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC1","description":"ICD-BEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1302","description":"CDT-D1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018U","description":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53430","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9734","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD0","description":"ICD-FBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB1","description":"ICD-MKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Amnicore pro+_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4299","description":"Amnicore pro+_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA1","description":"ICD-CDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF0","description":"ICD-KIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA0","description":"ICD-DGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC1","description":"ICD-NJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93460","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","description":"HCPCS-M1377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA0","description":"ICD-OBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF1","description":"ICD-CFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99452","description":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mohs 1 stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17313","description":"Mohs 1 stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA0","description":"ICD-JIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC0","description":"ICD-PHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE1","description":"ICD-KEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Av fusion/forearm vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36820","description":"Av fusion/forearm vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC1","description":"ICD-FGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE1","description":"ICD-PDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME1","description":"ICD-AIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA220","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pulm function test by gas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94727","description":"Pulm function test by gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31239","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA1","description":"ICD-GHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA0","description":"ICD-KBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography head w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70544","description":"Mr angiography head w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF0","description":"ICD-CCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE1","description":"ICD-HDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93283","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech evaluation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70371","description":"Speech evaluation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB0","description":"ICD-CAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF0","description":"ICD-FGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ureteral embolization/occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50705","description":"Ureteral embolization/occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD1","description":"ICD-JAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00912","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","description":"CPT-00912","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE0","description":"ICD-OHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87582","description":"M.pneumon dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB0","description":"ICD-KBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE1","description":"ICD-OAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE131","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk12.6-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12005","description":"Rpr s/n/a/gen/trk12.6-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB1","description":"ICD-IGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8664","description":"Fun stat score shdl < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB0","description":"ICD-KAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC1","description":"ICD-EEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Emergency tracheotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7990","description":"Emergency tracheotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 probe&reverse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87535","description":"Hiv-1 probe&reverse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD1","description":"ICD-OLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA11","description":"ICD-2DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA0","description":"ICD-NLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC1","description":"ICD-BCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC0","description":"ICD-JHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE1","description":"ICD-PFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA0","description":"ICD-EGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE0","description":"ICD-MIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE131","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE0","description":"ICD-GFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF1","description":"ICD-FEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB145","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC0","description":"ICD-NLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE1","description":"ICD-JEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA0","description":"ICD-HIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42960","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB1","description":"ICD-MAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1111T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1111T","description":"CPT-1111T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High strength ltwt whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0004","description":"High strength ltwt whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0450","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC1","description":"ICD-LAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93598","description":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay phosphatidylglycerol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84081","description":"Assay phosphatidylglycerol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA1","description":"ICD-BIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1024","description":"Nonpneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ald_ tv amplifier_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5270","description":"Ald_ tv amplifier_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC0","description":"ICD-CBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0801","description":"Pov group 1 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA1","description":"ICD-LBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Streptozocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9320","description":"Streptozocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF1","description":"ICD-OELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1084","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF0","description":"ICD-CCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0A","description":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD0","description":"ICD-IDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Residual limb support system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1020","description":"Residual limb support system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC1","description":"ICD-KHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF1","description":"ICD-OLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted reprod med lab proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89398","description":"Unlisted reprod med lab proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC0","description":"ICD-EETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11643","description":"Exc f/e/e/n/l mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45300","description":"Proctosigmoidoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj perflexane lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9955","description":"Inj perflexane lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr pul art unifocal w/o cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33925","description":"Rpr pul art unifocal w/o cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF0","description":"ICD-MEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44625","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC0","description":"ICD-KCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional neuromuscularstim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0764","description":"Functional neuromuscularstim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB1","description":"ICD-GHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25270","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nephropathy doc tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3066F","description":"Nephropathy doc tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD0","description":"ICD-OAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB1","description":"ICD-JEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC1","description":"ICD-GBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86701","description":"Hiv-1antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB1","description":"ICD-FIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD1","description":"ICD-OGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD0","description":"ICD-EGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC0","description":"ICD-LAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq abltj lvr cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47383","description":"Perq abltj lvr cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA0","description":"ICD-PIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng prgrm eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305T","description":"Icar ischm mntrng prgrm eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD0","description":"ICD-PKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tildrakizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3245","description":"Injection_ tildrakizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD1","description":"ICD-BGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7502","description":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF1","description":"ICD-IFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD1","description":"ICD-ODWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lens surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14251","description":"Anesth lens surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21346","description":"Opn tx nasomax fx w/fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF1","description":"ICD-GHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE0","description":"ICD-JHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB0","description":"ICD-JGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC0","description":"ICD-LIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF1","description":"ICD-NLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28660","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB0","description":"ICD-JAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lever-activated wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0988","description":"Lever-activated wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9161","description":"Lang comp d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Ramucirumab_ 5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9025","description":"Injection_ Ramucirumab_ 5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB0","description":"ICD-CHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC0","description":"ICD-AHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiograph head w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70546","description":"Mr angiograph head w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cuffs adj lock w/ active con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3740","description":"Cuffs adj lock w/ active con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB0","description":"ICD-CGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB0","description":"ICD-GAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD0","description":"ICD-NFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE0","description":"ICD-GDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine proces distract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171T","description":"Lumbar spine proces distract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC0","description":"ICD-NKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB0","description":"ICD-ICIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD0","description":"ICD-EHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1342","description":"Patients who died during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB14","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Plastic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4027","description":"Plastic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB1","description":"ICD-FBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon hydrochloride/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1610","description":"Glucagon hydrochloride/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA1","description":"ICD-ODFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF1","description":"ICD-EBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB0","description":"ICD-FECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adult disp brief/diap abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4543","description":"Adult disp brief/diap abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"5+ cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4209","description":"5+ cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB0","description":"ICD-NDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA0","description":"ICD-NGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE0","description":"ICD-FBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00846","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","description":"CPT-00846","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF0","description":"ICD-KGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA0","description":"ICD-LDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF1","description":"ICD-OBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20700","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA0","description":"ICD-JFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD0","description":"ICD-KASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assistive Technology","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0138","description":"Assistive Technology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA0","description":"ICD-OEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB0","description":"ICD-MHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA1","description":"ICD-IFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dimenhydrinate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1240","description":"Dimenhydrinate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0602","description":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB1","description":"ICD-MCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME0","description":"ICD-IIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD1","description":"ICD-EICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No srch for ct in 12mo norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9342","description":"No srch for ct in 12mo norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum deep <5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27619","description":"Exc leg/ankle tum deep <5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sedation (non-iv)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9248","description":"Sedation (non-iv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE0","description":"ICD-OCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31288","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73225","description":"Mr angio upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA0","description":"ICD-OBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX16","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC0","description":"ICD-LEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6121","description":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD1","description":"ICD-BCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA0","description":"ICD-GBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy for mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4210F","description":"Ace/arb thxpy for mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD1","description":"ICD-NLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco counseling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1320","description":"Tobacco counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF1","description":"ICD-GBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23545","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE1","description":"ICD-AIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC0","description":"ICD-NKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF0","description":"ICD-MJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of neck wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15825","description":"Removal of neck wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gi endoscopic ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76975","description":"Gi endoscopic ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF0","description":"ICD-GDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE1","description":"ICD-NACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB1","description":"ICD-BHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00102","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","description":"CPT-00102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB0","description":"ICD-CBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drain bl w/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51102","description":"Drain bl w/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dc power adapter_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1358","description":"Dc power adapter_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB113","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Back school visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9117","description":"Back school visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC1","description":"ICD-OKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"In-home respite care_ 4-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0529","description":"In-home respite care_ 4-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add leather insol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3500","description":"Ortho shoe add leather insol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF0","description":"ICD-ECCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD0","description":"ICD-ODTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Recement inlay onlay or part","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2910","description":"Recement inlay onlay or part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC0","description":"ICD-PHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma pool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9070","description":"Pathogen reduced plasma pool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hep a vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4155F","description":"Hep a vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB0","description":"ICD-OEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Calculus assay quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82360","description":"Calculus assay quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB1","description":"ICD-OCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluorescent study_ each antibody; indirect method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88347","description":"Immunofluorescent study_ each antibody; indirect method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE1","description":"ICD-NDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 10 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP10","description":"Auto.test pane pricing code_ 10 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD1","description":"ICD-BGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB0","description":"ICD-JCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC1","description":"ICD-OKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2616","description":"Pos back post/lat wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1022","description":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA0","description":"ICD-KBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE1","description":"ICD-DIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF1","description":"ICD-KEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA0","description":"ICD-DEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE0","description":"ICD-ABLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC0","description":"ICD-OHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA44","description":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB0","description":"ICD-IDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB0","description":"ICD-BFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD0","description":"ICD-ADMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE0","description":"ICD-KBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Perq & icut allg test venoms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95017","description":"Perq & icut allg test venoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC0","description":"ICD-ODYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF1","description":"ICD-CFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","description":"HCPCS-M1385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB0","description":"ICD-OEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of amikacin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80150","description":"Assay of amikacin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cytp fna eval ea addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88177","description":"Cytp fna eval ea addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE0","description":"ICD-GEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML23","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA0","description":"ICD-BBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rbc leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9016","description":"Rbc leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB1","description":"ICD-BHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF0","description":"ICD-FIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tinnitus assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92625","description":"Tinnitus assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF0","description":"ICD-IGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF1","description":"ICD-FGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC0","description":"ICD-NILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB26","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ burosumab-twza_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0584","description":"Injection_ burosumab-twza_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF0","description":"ICD-CGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bp scrn perf rec interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8783","description":"Bp scrn perf rec interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE0","description":"ICD-FGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD0","description":"ICD-OIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Assay of natriuretic peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83880","description":"Assay of natriuretic peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Aripiprazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0400","description":"Aripiprazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bowel to bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44130","description":"Bowel to bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF0","description":"ICD-OIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB56","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE0","description":"ICD-CDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ring flange plas/leather mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1110","description":"Ring flange plas/leather mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA0","description":"ICD-NILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED0","description":"ICD-CGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF1","description":"ICD-JEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA1","description":"ICD-CEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA1","description":"ICD-IFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1204","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0100","description":"Residential Habilitation 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0703","description":"HCPCS-A0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9039","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86328","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB0","description":"ICD-KDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF0","description":"ICD-HFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA1","description":"ICD-NGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF1","description":"ICD-OKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37276","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","description":"CPT-37276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remove uterus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59100","description":"Remove uterus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE0","description":"ICD-GHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD1","description":"ICD-HIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj melphalan hydrochl 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9245","description":"Inj melphalan hydrochl 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF0","description":"ICD-EAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0576T","description":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81237","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0593U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","description":"CPT-0593U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC43","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Excise breast duct fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19112","description":"Excise breast duct fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC1","description":"ICD-DHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic art therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37211","description":"Thrombolytic art therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD0","description":"ICD-NBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB0","description":"ICD-JFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tooth root removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7250","description":"Tooth root removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF1","description":"ICD-EELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA1","description":"ICD-OINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL02","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96567","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42970","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE0","description":"ICD-FABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD1","description":"ICD-IHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA1","description":"ICD-NKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21812","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42826","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supp not othrws c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9999","description":"Parenteral supp not othrws c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF1","description":"ICD-EAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB0","description":"ICD-OKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE1","description":"ICD-AFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC1","description":"ICD-FDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC0","description":"ICD-BEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF1","description":"ICD-JAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE1","description":"ICD-JCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64467","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","description":"CPT-64467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8E","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-60660","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","description":"CPT-60660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","description":"HCPCS-J3375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF1","description":"ICD-KBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3967","description":"Sewho airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93454","description":"Coronary artery angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB11","description":"ICD-4FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD0","description":"ICD-LGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9259","description":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA0","description":"ICD-NETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27495","description":"Reinforce thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE1","description":"ICD-GDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1082T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1082T","description":"CPT-1082T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA0","description":"ICD-GAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8E","description":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26412","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj xtrspinl 1/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98943","description":"Chiropract manj xtrspinl 1/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357U","description":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA31","description":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20827","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (ingenus)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9073","description":"Injection_ cyclophosphamide (ingenus)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE1","description":"ICD-CDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC0","description":"ICD-ECTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF0","description":"ICD-GHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE0","description":"ICD-AALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Wound filler dry form / gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6262","description":"Wound filler dry form / gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8010","description":"Limited dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9933","description":"Clean & inspect rem dent man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF1","description":"ICD-OCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Staph a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87640","description":"Staph a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD0","description":"ICD-MJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture skin/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88233","description":"Tissue culture skin/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE0","description":"ICD-KBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","description":"HCPCS-J3387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390T","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB231","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC53","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE1","description":"ICD-DASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sho lift taper to metatarsal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3300","description":"Sho lift taper to metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB0","description":"ICD-CEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0019","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"No bp measure doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8756","description":"No bp measure doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE1","description":"ICD-HHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD1","description":"ICD-MFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Non coring needle or stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4212","description":"Non coring needle or stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC1","description":"ICD-CBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0679T","description":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","description":"HCPCS-A2035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB1","description":"ICD-NLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA1","description":"ICD-NJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng chldbrng women epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4340F","description":"Cnslng chldbrng women epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo hormon antineopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96402","description":"Chemo hormon antineopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic refl threshold tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92568","description":"Acoustic refl threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB1","description":"ICD-KBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF0","description":"ICD-CEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF0","description":"ICD-AGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC0","description":"ICD-KBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81363","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Explore deep node(s) neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38542","description":"Explore deep node(s) neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD0","description":"ICD-GGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB0","description":"ICD-NDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE1","description":"ICD-OLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA0","description":"ICD-EIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92653","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0293","description":"Hosp bed var ht w/o rail w/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF1","description":"ICD-BAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC1","description":"ICD-AAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2526","description":"Th/wght bear nar m-l brim cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF0","description":"ICD-PKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Electro-uroflowmetry first","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51741","description":"Electro-uroflowmetry first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer water collec devic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7012","description":"Nebulizer water collec devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6607","description":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF0","description":"ICD-NBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30020","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD1","description":"ICD-OFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF1","description":"ICD-JFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Biodfence dryflex_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4138","description":"Biodfence dryflex_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC0","description":"ICD-BHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA135","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Anesth tympanotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12651","description":"Anesth tympanotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ligate oviduct(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58611","description":"Ligate oviduct(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA1","description":"ICD-PHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA1","description":"ICD-JFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB0","description":"ICD-IFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD0","description":"ICD-KHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft brchl-ulnr-rdl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35523","description":"Art byp grft brchl-ulnr-rdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA1","description":"ICD-IILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8H","description":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9064","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311U","description":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC0","description":"ICD-PCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE1","description":"ICD-EDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA0","description":"ICD-GFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96422","description":"Chemo ia infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA1","description":"ICD-EIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC1","description":"ICD-NJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD0","description":"ICD-MCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pwr pack base elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0488","description":"Pwr pack base elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0522U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","description":"CPT-0522U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF1","description":"ICD-PCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC0","description":"ICD-NKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE1","description":"ICD-JHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD1","description":"ICD-GFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA121","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Open tx post pelvic fxcture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0415","description":"Open tx post pelvic fxcture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514T","description":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Joint device (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1776","description":"Joint device (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extended steel shank","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2360","description":"Extended steel shank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50727","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Disposable canister for pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7000","description":"Disposable canister for pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB0","description":"ICD-CCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0365","description":"Cone beam ct interprete man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE0","description":"ICD-PAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","description":"CPT-01638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pm device interrogate remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93294","description":"Pm device interrogate remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9846","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA0","description":"ICD-JEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE1","description":"ICD-CGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked uppr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95928","description":"C motor evoked uppr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6560","description":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF0","description":"ICD-KCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99416","description":"Prolong clincl staff svc add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75822","description":"Vein x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reass appr remo filt 3ms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9542","description":"Doc reass appr remo filt 3ms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE0","description":"ICD-GFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD1","description":"ICD-CGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Spinal fluid tap diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62270","description":"Spinal fluid tap diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE1","description":"ICD-CITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442T","description":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD0","description":"ICD-JDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB125","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB1","description":"ICD-OIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00790","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","description":"CPT-00790","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE0","description":"ICD-IBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tibia & fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27709","description":"Incision of tibia & fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE244","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1336","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES215","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC0","description":"ICD-FGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE0","description":"ICD-MDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE1","description":"ICD-FAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD1","description":"ICD-OFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA1","description":"ICD-EHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC1","description":"ICD-NJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC1","description":"ICD-HDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD0","description":"ICD-MFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF1","description":"ICD-BAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB0","description":"ICD-GGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6601","description":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD0","description":"ICD-CGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC1","description":"ICD-MLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92651","description":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND1","description":"ICD-BAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB236","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 250-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9961","description":"Hocm 250-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pin knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26706","description":"Pin knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA1","description":"ICD-NCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB0","description":"ICD-CESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD1","description":"ICD-KAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95249","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8C","description":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8X","description":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE0","description":"ICD-FAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE1","description":"ICD-HFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD0","description":"ICD-EDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Adrenalin epinephrine inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0171","description":"Adrenalin epinephrine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF0","description":"ICD-NGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC21","description":"ICD-1EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA0","description":"ICD-OIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC1","description":"ICD-GEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC1","description":"ICD-OGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC21","description":"ICD-2LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB0","description":"ICD-CIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73085","description":"Contrast x-ray of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Sumatriptan succinate / 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3030","description":"Sumatriptan succinate / 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC1","description":"ICD-OIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD0","description":"ICD-ECBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81283","description":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC1","description":"ICD-OECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE0","description":"ICD-EECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Speech sound lang comprehen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92523","description":"Speech sound lang comprehen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"L ventric pacing lead add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33225","description":"L ventric pacing lead add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF1","description":"ICD-LHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34705","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5109","description":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44346","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC1","description":"ICD-GGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC0","description":"ICD-AEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24201","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC0","description":"ICD-BDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC0","description":"ICD-JEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB0","description":"ICD-LDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43193","description":"Esophagoscp rig trnso biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA1","description":"ICD-JEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27175","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas no hospice refer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9525","description":"Doc pt reas no hospice refer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE0","description":"ICD-JFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Dilated fundus eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2020F","description":"Dilated fundus eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57540","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE115","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD0","description":"ICD-PKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF1","description":"ICD-OHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1028","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46900","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Psori tool doc w/benchmk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9649","description":"Psori tool doc w/benchmk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","description":"HCPCS-J9183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","description":"HCPCS-J0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF1","description":"ICD-MLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Compounded drug_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7999","description":"Compounded drug_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB1","description":"ICD-KGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63276","description":"Bx/exc xdrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv push addl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96411","description":"Chemo iv push addl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF1","description":"ICD-BHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC0","description":"ICD-EACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Hd low limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5782","description":"Hd low limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA0","description":"ICD-BFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD0","description":"ICD-GFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB31","description":"ICD-2AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE0","description":"ICD-BHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE0","description":"ICD-CAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Resect recurrent gyn mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58957","description":"Resect recurrent gyn mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Drive belt power wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0098","description":"Drive belt power wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Trg gene rearrangement anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81342","description":"Trg gene rearrangement anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg3/4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9115","description":"Onc dx ovarian stg3/4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC0","description":"ICD-NFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45380","description":"Colonoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye thickness","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76514","description":"Echo exam of eye thickness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC0","description":"ICD-KGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF1","description":"ICD-NDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB0","description":"ICD-GBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB244","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12018","description":"Rpr f/e/e/n/l/m >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID0","description":"ICD-ABID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Surface emg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3900","description":"Surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF0","description":"ICD-OCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD0","description":"ICD-CFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD0","description":"ICD-GHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB0","description":"ICD-BIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD1","description":"ICD-CBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF1","description":"ICD-GBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"B cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86355","description":"B cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC31","description":"ICD-1FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC0","description":"ICD-HDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE0","description":"ICD-NBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF0","description":"ICD-AAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE0","description":"ICD-PFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC1","description":"ICD-FFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD1","description":"ICD-FEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF1","description":"ICD-JAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0533T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Documentation stating the patient has received or is currently receiving palliative or hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1307","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1821","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","description":"HCPCS-L1821","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1944","description":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA1","description":"ICD-CGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1049","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Tech other than surfc cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4261F","description":"Tech other than surfc cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Restorative foundation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2949","description":"Restorative foundation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA1","description":"ICD-IDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70480","description":"Ct orbit/ear/fossa w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD0","description":"ICD-BGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC1","description":"ICD-NBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF1","description":"ICD-CECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC0","description":"ICD-BDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD0","description":"ICD-GHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1402","description":"HCPCS-A1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB0","description":"ICD-OIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67210","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC260","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF1","description":"ICD-ODCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Portable 02 contents_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0444","description":"Portable 02 contents_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF1","description":"ICD-IGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX31","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9786","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES254","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9472","description":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB1","description":"ICD-JENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0702T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC0","description":"ICD-CEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB0","description":"ICD-HIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA1","description":"ICD-BCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0321","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA1","description":"ICD-OLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD112","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF1","description":"ICD-MDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE1","description":"ICD-GDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB0","description":"ICD-NBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Fluoro polarize fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83663","description":"Fluoro polarize fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD1","description":"ICD-NBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26433","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no pos air press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8849","description":"Doc reas no pos air press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp <5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99143","description":"Mod sedat phys/qhp <5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0720T","description":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC1","description":"ICD-CCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB0","description":"ICD-MALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2104","description":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF0","description":"ICD-ODPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD0","description":"ICD-FEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE1","description":"ICD-OAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2040","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","description":"HCPCS-A2040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD1","description":"ICD-JHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA1","description":"ICD-LGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC0","description":"ICD-GFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Inj protamine sulfate/10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2720","description":"Inj protamine sulfate/10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4028","description":"Cast sup hip spica ped fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93975","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC0","description":"ICD-OFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pro flex/ext cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5859","description":"Knee-shin pro flex/ext cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64836","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0701","description":"HCPCS-A0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33956","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD1","description":"ICD-EETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA0","description":"ICD-HEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE1","description":"ICD-DCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE1","description":"ICD-KAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[244010155]}]}]}